Universal Childhood Immunization (UCI)--in its more localized context referred to as
Expanded Program of Immunization (EPI)--stands worldwide as a top health programming
priority among various multilateral, bilateral, and nongovernmental (NGO) international
development agencies. This appears to be the case because immunization programs are widely
accepted and actively promoted as offering recipient beneficiaries more substantive
disease prevention benefits than any other modality in the arsenal of modern medicine,
coupled to its unique capacity to offer the surest and "quickest" results. When
compared to the more basic intersectoral and developmental requisites for public health
sustenance and disease prevention, UCI/EPI is generally considered to be the easiest to
implement programmatically, promote publicly, and defend politically. The World Health
Organization (WHO) has gone on record to affirm that, "Immunization is one of the
most powerful and cost-effective weapons of modern medicine. Immunization services,
however, remain tragically under-utilized in the world today."1

Despite the Canadian govemment's confirmed support of the comprehensive primary health
care approach--as defined in the Alma Ata Declaration--the majority of increases in the
Canadian International Development Agency (CIDA) Health Sector disbursements, in the last
half of the 1980s, have been for the selective and vertical modality of UCI/EPI. In fact,
according to observations made in the 1989, Evaluation Assessment of CIDA Investments
in the Health Sector, immunization has become the dominant health activity supported
by CIDA. "Annual disbursements over the past three years have risen from $3 to $22,
to $49 million."2 The lion's share of this increase stemmed from the launching of Canada's
International Immunization Programme (CIIP), covering the period of 1986-1991. (An October
10, 1991 Fact Sheet on Canada's Role in Immunization, states that of the $43
million expended by CIIP in the period 1985-1990, involved the execution--by more than 30
nongovernmental organizations--of over 100 projects in more than 50 countries. When we
include the government-to-government [bilateral] program, total CIDA funds committed to
UCI/EPI in the 1986/1987-1990/1991 fiscal year periods equal some $143 million. At the end
of 1991/1992 it was the intention of the government to expend roughly another $50 million
on UCI/EPI over the next five years, with about $30 million for CIIP II.) According to a
Mid-Term CIIP Operational Review completed November 20, 1989, UNICEF took almost
$27 million from the Program for 37 EPI projects, amounting to 67% of CIIP funds.
Additional CIIP funding passed indirectly to UMCEF, via Rotary for vaccine purchases, and
via Canadian partners who purchased project equipment from UNICEF stockpiles.3

Speaking of this major shift in priorities, wherein by the end of the 1980s immunization
support accounted for one half of all health sector disbursements, the CIDA Health
Sector Evaluation Assessment recommended that "this situation merits examination
on the grounds of both the heavy focus by CIDA on this one type of health program and the
nature of immunization efforts . . . Primary Health Care is more complex and multifaceted
then the provision of this one . . . technology."4 This need to re-examine immunization
support was further affirmed when the Assessment identified certain "important am
that merit further review," including: case studies of the health impact of projects
involving or crossing varied sectors; the level of sustainability achieved in completed
CIDA health projects; and areas of large spending or of controversy, i.e.,
immunization."5

Although the Assessment did not go on to define the nature of the controversies
surrounding immunization, mass immunization programs have been seriously questioned on
both developmental and scientific grounds. It will be the purpose of this report to
proceed with a detailed examination of the issues of controversy, draw some conclusions,
and make appropriate recommendations. The critique of these issues stems from a careful
review and evaluation of wide ranging biomedical literature sources of relevance to the
subject. This work has been carried out in the spirit of honest inquiry, thus affording a
fresh and critical analyses of the fundamental issues.

Although the conclusions as reached visibly sustain "one side" of what is
largely a hidden and professionalist dominated debate on immunization, the reader should
note that this is done in order to provide a long neglected and constructive
counterbalance to the predominating supportive declarations of the establishment, and in
turn the parroted promotion of the same view by the popular media.

It must further be appreciated that past and ongoing investments in the drive for
universal immunization extend well beyond the mere allocation of substantial government
and publicly donated funds (which translates into biennial expenditures of a billion US
dollars, 63 percent of which comes from Developing World countries themselves)6 to include:

extensive public and private sector commitment to meeting the
infrastructural, service, product and marketing requirements of the world-wide
medico-industrial complex which employs tens of thousands of people in drug companies,
private laboratories, universities, governmental health departments, hospitals etc.
(furthermore it is estimated that there are 25,000 professional national and international
staff who directly oversee hundreds of thousands of field workers involved in the annual
vaccination of 60 million children);7

related domestic and international legislation and politics; and

massive public educational indoctrination initiatives that are largely
predicated on promoting the unquestioned effectiveness and relative safety of
immunization, and which by design engender an impelling fear in those
"unprotected."

UNICEF's Executive Director has gone on record in many fora to herald
the substantive value and potency of immunization. In advance of the inception of Canada's
current and greatly expanded International Immunization program he gave a full and
unqualified assurance that "Expanded immunization--using newly improved
vaccines" will "prevent the six main immunizable diseases from killing an
estimated 5 million children a year and disabling 5 million more."8

The front page of the January/February, 1988, issue of Development Forum, published
by the U.N. Department of Public Information, unequivocally affirms that
"immunization is the success story of the decade. In the Developing World
immunization has reached 50 percent for DPT vaccine and 40 percent for measles, and is now
saving over 1.3 million lives annually." Everyone is encouraged--bordering on
religious fervor--to get on the bandwagon.

UNICEF.. calls for a 'Grand Alliance' of all possible resources
teachers, and religious leaders, mass media and government agencies, voluntary
organizations and people's movements, business leaders and labour unions, women's groups
and health services to create an informed public demand for. . . the methods which could
now bring about 'a revolution' in child survival and development. In Turkey, for example,
200,000 school teachers and 54,000 imams have helped to treble the nation's immunization
coverage. In Syria and Egypt, television has succeeded in getting the immunization message
into every home . . . UNICEF argues that 'there is no greater cause in which to march.' 9

Indeed, immunization has of late gained the distinction of being
considered the "leading edge" in primary health care, and is extolled by its
advocates as "the single most successful component of the child survival
program." Its high acceptance and apparent success relate to a number of factors:

A technological package that is easily understood and readily
available . . . the fact that vaccination does not require substantial behaviourial
change; the relative ease of measuring coverage and its offer of an opportunity for
political leadership at all levels to be visibly involved. Finally, it is the single
component of PHC that provides the greatest opportunity for the private sector to
participate through the supply or production of vaccine and cold chain equipment.10

It is accepted wisdom among medical professionals and in turn the
public, that millions of children now enjoy improved health and freedom from various
life-threatening diseases because of safe and effective vaccines. In the words of
Fulginiti, "morbidity and deaths secondary to the contagious diseases have either
been eradicated, measles greatly reduced in occurrence, and rubella, mumps, pertussis, and
other diseases significantly lessened in terms of their impact."11

This general examination of Immunization as a central modality in the prevention of common
infectious diseases in the Developing World will begin with some salient extracts taken
from the writer's findings in a field evaluation he carried out on a UNICEF--Expanded
Program of Immunization and Primary Health Care initiative in Northeast Thailand, in March
of 1990. The data derived from evaluating the EPI component is being provided as basic
background information because it provides some useful insights on comparable UNICEF-EPI
initiatives that are now occurring throughout the Developing World, and points to some
critical issues meriting further investigation. (EPI was one of eight components in the
Integrated Services Project for Children, extending over a five year period, at a cost
exceeding $8,500,000.(Cdn). This funding was primarily provided by the Canadian
Government, and supplemented with public contributions. The Project was executed by UNICEF
Thailand, in cooperation with the Royal Thai Government.)

The EPI in Northeast Thailand proved to be a considerable undertaking. It included: the
execution of a cluster survey on immunization coverage in all 59 districts (in which there
are over 900 villages); provision of EPI training for 600 Village Health Volunteers,
Village Health Communicators, and religious leaders; similar training for 200 health care
providers, and 40 multiple WHO staff, EPI information strengthening and finally social
mobilization to vaccinate, viz. provide BCG/OPV/DPT and measles coverage for all 59
districts. It further involved the equipping of 373 tambon (subdistrict) health centres
with sufficient numbers of. refrigerators; vaccine carriers with four icepacks; BCG
vaccine kits; thermometers; cold chain monitoring cards; and steam sterilizers.
The EPI initiative placed its strategic concentration on the following areas:

EPI training of village and religious leaders

emphasis on reaching progressively higher annual vaccination targets

provision of cold chain equipment and support to targeted Tambons

information campaigns in primary and elementary schools

public education campaigns in targeted villages

increased vaccine production; and

strengthening the EPI information system at the district and provincial
level.

In reviewing figures for the project covering the first three years
(1985-1987), the priority emphasis on immunization is evident. Project expenditures for
this component reached 126 percent of the original target for immunization, compared to
only 28 percent for primary health care. Food and nutrition fared somewhat better at 60
percent of the target, a little under the project average of 61 percent. A budget analysis
conducted on the project for this period states that "Implementation of the community
action component is . . . low. However, the savings obtained here will be passed on to the
EPI and pre-school components . . ." The reason given for exceeding the original
budget projections for EPI, was "because of the demands and opportunities for support
presented."12

Recognizing the central importance of "health care outcomes," both the
evaluation exercise and this broader examination of the issues have purposely focused on
concerns surrounding the qualitative issue of EPI health care outcomes and effectiveness.
However, it became readily apparent in the evaluation of the Program that--due to the
absence of base line data on any sample of the recipients, let alone the additional need
for a comparable control group, and the control or monitoring of intervening variables it
was not really possible to proceed with any accurate or verifiable determination of health
care outcomes (i.e., to establish a cause and effect relationship) for EPI.

This need to provide verifiable measurement of a program's health care outcomes appears to
be pervasively deficient throughout most health programming directed to the Developing
World. The implications of this general deficiency to the specific measurement or
determination of EPI effectiveness, remains a serious one, and will be addressed more
thoroughly at later points in this report.UNICEF'S GENERAL EPI
STRATEGY AND STATED ACHIEVEMENTS

In a UNICEF sponsored research study on immunization coverage conducted in Thailand in the
mid 80's, the following general observation is made:

[The] immunization programme has been proven to be an efficient, and
relatively inexpensive method of disease prevention in both developing and developed
countries. In the last decade, we have seen an increase in immunization usage, public
acceptance, improved delivery techniques and more stable vaccines. The more extensive use
of vaccines has resulted in a dramatic decrease of many leading communicable diseases in
all parts of the world. However, this condition is by no means true in developing
countries where most of the vaccine preventable diseases like diphtheria, pertussis,
neonatal tetanus, poliomyelitis and measles remain to be a serious health menace among
infants and children in these countries."13

The view as expressed here--during the early stages of this
project--provides a fair representation of the rationale behind UNICEF'S resolve to
proceed with its universal disease eradication drive, via vaccine induced immunization.
(It is of no passing interest that WHO and UNICEF sponsored literature, such as above, now
embody a new nomenclature, in which one does not refer to preventable diseases, but more
precisely "vaccine preventable diseases" thus tending to convey the
unsubstantiated conclusion that such diseases are only preventable through the use of
vaccines.)

In UNICEF's Fourth Progress Report on this project issued in 1989, it was affirmed that,
"Impressive progress has been made towards the achievement of Universal Child
Immunization (UCI). Immunization coverage has been increased and the incidence of
immunization diseases reported has reduced." This achievement was reported as taking
place despite such persistent obstacles as: insufficient "awareness and knowledge
among health officials and community leaders;" inadequate "availability of
vaccines and cold chain in remote areas;" and the problem of "drop-out due to
ignorance, distance, and fear of side effects."FIELD OBSERVATIONS

On the basis of structured and semi-structured interviews in five provinces, five
districts, and nine villages visited, the following facts came to light:

The EPI component objectives were comprehensively and successfully
implemented, exceeding the original numerical targets

EPI was reported as the "only activity that is implemented and
recorded entirely by government (health) officials"

All parents had been informed that: immunization was an effective, and
essential life-guarding measure, and although it could result in fever or a minor rash for
their infants, this should be expected as normal (a small price to pay for the benefits
received); and that otherwise the procedure was very safe and should pose no cause for
fear or alarm

The most commonly reported side effect of infant vaccinations was fever,
with village reports ranging from a low of 6% of infants immunized to "99%."
(Rashes were the second most commonly reported side effect)

Fever reducing drugs are either routinely administered to vaccinated
infants, or administered on request of parents (however, one village did report the
effective use of water instead of drugs to reduce fever), and

Sisaket province reported that "rare" cases of post-vaccination
shock have occurred, attributing this to vaccinal "overdose." Surin province
reported that there were cases of post-vaccination shock in various other provinces, but
not in Surin. Such cases were attributed to the vaccine vial not being "sufficiently
shaken."

Evidence indicated that the EPI program did not incorporate adequate measures for
contraindications pre-screening and post-monitoring.

All infants received the vaccines regardless of their weight or
nutritional status (only one village indicated that vaccines were not given to infants
severely underweight, and only one province reported post-vaccination monitoring of
infants under 3 kg).

Actual nutritional status assessment does not appear to be conducted on
infants (excepting the body weight factor) before administering vaccination.

There did not appear to be any procedural requirements for checking
family histories to determine whether there existed any history of neurological disorders
before administering vaccination.

The official view historically held and still articulated by the World
Health Organization (WHO) is that both the provision of screening for contraindications,
and post operation monitoring for adverse reactions are uncalled for in the context of
Developing World EPI campaigns. The underlying rationale has been that the life saving
benefits of EPI so far outweigh any risks, that attention to potential risk factors and
the potential for vaccine induced damage in vaccinates remains impracticable, and thus a
non-issue.14

Despite this unqualified optimism, according to information provided by CIDA's Health and
Population Directorate sector, the WHO effective October, 1990, instituted a policy for
"adverse event monitoring" in Developing World Immunization activities. A
definitive policy statement on this issue titled Monitoring of Adverse Events Following
Immunization, has been available since April 1991. (The implications of WHO's
recognition of the significance of this issue in setting UCI/EPI research, monitoring and
evaluation priorities should be apparent.)

It is thus important to point out that there is by no means a consensus on this issue
within the Bio-science community (including the inconsistencies exhibited in the public
pronouncements, and policies of the WHO). In one of the most recent scholastic manuals
available on immunization practice, noted authority, George Dick--Professor Emeritus of
Pathology, London University--provides the following cautions relative to the traditional
assumptions of the WHO:

Before considering immunization it must be determined that the disease in
question is of sufficient severity, frequency or other importance to justify immunization
against it. Furthermore, "if the infection is readily treatable, there is seldom
justification for immunization."

"immunization is indicated only when the classic methods of control
are [demonstrably] impracticable or unsuccessful."

Before any vaccine is introduced "there must be good evidence that
the vaccine is effective and relatively safe . . . Sufficient time has not yet elapsed to
predict with any certainty the durability of immunity with the live virus vaccines, which
are now in common use, such as poliomyelitis, measles . . . [etc.]"

"The best type of active immunization follows a clinical or
subclinical natural infection. With many diseases this often gives lifelong protection at
little or no cost to the individual or to the community."

The pre-immunization era declines in infectious diseases "should
make one careful in attributing changes in the epidemiology of some diseases to the result
of a specific treatment or immunization."15

He further confirms that in the following conditions, the EPI vaccine as
noted should not be administered. (Obviously pre-vaccine screening measures must be in
place in order to ensure that these guidelines are met.) Dick's recommendations follow on
Table A.

TABLE A -- GUIDLINES FOR CONTRAINDICATIONS SCREENING

Diphtheria

acute febrile illness (fever)

Whooping Cough
(pertussis)

acute febrile illness

a history of seizures, convulsions or cerebral irritation in the
neonatal period

any neurological defects

any severe local or general reaction to a previous dose of
pertussis

"Children whose parents or siblings have a history of
idiopathic epilepsy or neurological defects require careful assessment as to the
advisability of imunization."

Polio

acute illness including diarrhoea, or other (OPV) acute intestinal
dysfunction

sever hypogammaglobulinaemia

anyone on corticosteroids or immunosuppressive therapy

Measles

acute febrile illness

immune mechanism deficiencies

anyone on corticosteroids or immunosuppressive therapy

Hodgkin's disease and leukaemia, or other diseases of the lymphoid,
or mononuclear phagocytic (reticuloendothelial) system

Preliminary PHC and EPI research conducted for CIDA's Evaluation Division indicates as
well that vaccines should not be administered to children who are suffering from
malnutrition due to associated immunodeficiency problems (of which--inter alia--chronic
infections are symptomatic). However, the official WHO position on this point is that
"Fever, respiratory tract infections, diarrhea, and malnutrition should not be
considered as contraindications to immunization." This is based on the relationship
between immunodeficiency status and increased risk of natural infection.

16, 17, 18 (For a cross-sampling of other
reference sources which support a counter-view to the WHO stance on immunodeficiency and
contraindications to vaccines, please see ref.18)

The Project's failure to address this issue--in a responsible manner--has undoubtedly
caused some very real harm, when only good was meant, as the following shows.

Upon completing the briefing session with a large contingent of Surin provincial and
Northeast regional health officials--at which the chief provincial spokesperson confirmed
that although post-vaccination shock was a problem in other provinces, there were no known
cases being reported in his province evaluation team members departed for their respective
village destinations. Upon entering the village of Kanjarong, in the Chom Phra district
(only 35 miles distant from the provincial capital) in company with the UNICEF Integrated
Services Project Monitor, we encountered and met with the village Head Man and the Deputy
Head Man.

In the course of the interview, the Deputy Head Man, with some intensity explained that
his own son had experienced what he considered as very serious damage as a result of
immunization. The Project Monitor and I returned the following day, at which time we both
interviewed the mother and observed the affected child during the interview. As a result
of this more careful and thorough interview, the following facts of the case were
ascertained:

Up to the age of 3 months the infant had been breastfed. Breastfeeding
was terminated by the mother due to a diagnosed thyroid deficiency, per the
"doctor's" request. She subsequently began feeding him powdered milk,
supplemented by egg, meat, and white rice. The use of fresh fruit and vegetables in the
infants diet remained very marginal.

At the age of 8 months the infant was taken in for his final DPT (triple
antigen) vaccine. He almost immediately went into what was diagnosed and described as a
state of "shock," for which he was duly treated by a physician. As well, a whole
series of serious problems began:

chronic sleeplessness

high fever

unbroken colds and runny nose continuing over several months

unbroken crying (except when held) for a period exceeding 2 months

in the eleven months following the vaccine (the child at time of
inter-view was I year 7 months) there appeared to be severely impaired weight and growth
developments.

Although cognizant that this case
history could be construed (and in turn dismissed) as a rare anecdotal occurrence that was
only coincidental to the administration of the triple antigen vaccine, after careful
thought I've decided to included it in some detail for three basic reasons:

I. evidence suggest that for multiple reasons--as noted throughout this
document--such adverse reactions are likely to be taking place at a significantly greater
level than is popularly believed;

II. a calm, intelligent and caring mother's direct experiential
observations and hindsight about her child represent a fully valid and trustworthy source
of information; and

III. overall, the clarity and force of the evidence was such that the
child's reaction was clearly more than a mere coincidence, and thus not attributable to
other direct causes. (As well there is clear evidence suggesting that the occurrence and
severity of adverse reactions to vaccines--among infants--correlate proportionally to both
lack of breasffeeding, and Vitamin C deficiency (e.g., see refs. 17 & 18).

The following comments should be made with respect to points (a)-(e)
above:

The unbroken crying (its unfortunate that children under the age of one
can't verbally explain the nature and extent of their distress) suggest the possibility of
permanent nervous system damage. (In observing the child walk about, it was visibly
evident that his general motor functions and coordination were impaired.)

The reported growth stunting effect was also visibly obvious, as the
child appeared to be at most the size of a one year old. (In that impaired growth is
generally not identified in the literature as a vaccine related or induced hazard, this
condition may well have been principally related to other factors bearing on the child's
nutritional intake and or assimilative capacities.) The mother reported that his weight at
birth was 4 kilos (a very heavy baby by Thai standards) and at 5 months, 9 kilos. At the
time we visited--though now I year and 2 months older--his weight was unchanged, still at
9 kilos.

It is also worth noting that the mothers three month old grandson, who was present during
the interview, had been experiencing high fever, and continuous colds since having
received recent inoculations. Given that I visited only 9 out of over 900 participating
villages, and then only raised this issue with a fraction of respondents, poses serious
concern as to just how widespread and serious the problem of adverse side effects is.

It is known for instance that when mass immunization programs were enforced in Australia's
Northern Territory among what was a generally malnourished Aboriginal population (the most
notable concern being Vitamin C deficiency) death rates doubled, in some areas approaching
50 percent i.e., "Every Second Child." According to the author of a book by that
title and veteran physician to the Aboriginals A. Kalokerinos:

A health team would sweep into an area, line up all the Aboriginal
babies and infants and immunize them. There would be no examination no taking of case
histories, no checking on dietary deficiencies. Most infants would have colds. No wonder
they died Some would die within hours . . . Others would suffer immunological insults and
die later from pneumonia, 'gastroenteritis'or 'malnutrition'.19

In Northeastern Thailand, in the villages visited practically all
mothers were breastfeeding, and were to some extent including fresh garden vegetables and
fruit in their diets. This in turn provided a fair degree of protection from the kind of
severe reactions and mortality just noted among Australian Aboriginals. Nonetheless, it is
apparent that there still remains a sizable number of malnourished. To quote C. Guthrie:

Malnutrition seems to be declining in the Northeast... Still,
malnutrition is widely prevalent. One does not need to go looking for it. In one school .
. . in Don Luang, 50 percent of the children were suffering from one level of malnutrition
or another. I found it somewhat disturbing to find that the objective expressed by most
officials was restricted to the eradication of 3rd degree malnutrition, in spite of the
wide prevalence of 1st and 2nd degree malnutrition.20

It appears that the mass coverage obsession common to UCI and EPI, have
run roughshod over the repeated qualifications, and warnings that have been issued against
administering vaccines to inimunodeficient infants and children, of which malnutrition is
a prime indicator. The fact that a March 1988 Annual Report on this Project (p. 5)
indicated that a WHO/UNICEF review team found that EPI "drop out rates were high,
because of the fear of side effects as expressed by mothers," suggests that the
prevalence of vaccine induced complications and morbidity in Northeast Thailand, may well
be more significant than heretofore thought. (The broader question and implications of
vaccine induced morbidity and mortality will be examined in more detail, later in the
report.)

The rationale behind administering multiple vaccines and toxoids throughout the first 14
week period of an infant's life (excepting measles) is that in the first year of
life--when the immune system is still relatively immature--a child is considered more
susceptible to most infectious diseases. However, this view fails to admit the corollary
that the immune and nervous systems of infants, are immature thus making them potentially
more vulnerable to the toxic effects of vaccines and toxoids.

Nonetheless, the argument is commonly raised that vaccines must be administered in accord
with the recommended schedule," (particularly in the Developing World), as the risk
of dangers is so marginal, and the dangers of widespread and unchecked infectious diseases
so great that the infant must have the vaccines--or else. Of course this view is
acceptable only insofar as the multiple beliefs surrounding UCI/EPI are valid, i.e., that
there are no better disease preventative measures; that the presence of such infections
cannot be safely handled or treated; and that vaccines are both highly effective and very
safe.

It is instructive to consider the experience of Japan in this regard. Delay of DPT
immunization until 2 years of age in Japan has resulted in a dramatic decline in adverse
side effects. In the period of 1970-1974, when DPT vaccination was begun at 3 to 5 months
of age, the Japanese national compensation system paid out claims for 57 permanent severe
damage vaccine cases, and 37 deaths. During the ensuing six year period 1975-1980, when
DPT injections were delayed to 24 months of age, severe reactions from the vaccine were
reduced to a total of eight with three deaths. This represents an 85 to 90 percent
reduction in severe cases of damage and death.

21

Although it is obvious that conditions in Japan remain distinctive from that of most
Developing World countries, it must be noted that insofar as susceptibility to infectious
disease remains greater in lesser developed countries, it clearly follows that
susceptibility to vaccine damage will also be proportionally greater. Thus the lesson from
Japan carries a valid message relative to the prevention of vaccine damage in Developing
World EPI campaigns.IMMUNIZATION'S
IMPACT IN THE DECLENSION OF INFECTIOUS DISEASES

Statistics indicate that over the life of this project, Thailand (and presumably the
Northeast region, for which direct figures were not available) has exhibited some degree
of declension in childhood infectious diseases (excepting measles) for which immunization
has--in recent years--been made generally available. However, it must be borne in mind
that prima facie improvement in morbidity levels--in end of itself--falls far short of
proving any actual interventional cause and effect relationship for EPI.

Direct discussions with the International Development Research Centre's Health Sciences
Division confirms that in selective primary health care activities, such as EPI, there
exists "no good base line data from which to measure health care outcomes. SPHC
(Selective Primary Health Care) programs in the implementation of EPI appear to ignore
this whole issue," Due to the strong and widely maintained assumption that
interventions such as EPI serve inextricably and directly as the basis for health
improvement outcomes, there has been a general failure since the inception of the first
vaccine programs to establish genuinely verifiable evidence for their long term
effectiveness, and safety. 22

The general nature of this problem in Selective Primary Health Care activities is well
expressed by prominent Medical Sociologist J. Williamson, when he says there has been a
failure to "assess explicitly the degree of validity and sufficiency of the evidence
linking care structures (facilities, personnel), and processes (what providers do, e.g.,
EPI) to outcomes of care in general and to health outcomes in particular."23

Epidemiological science is largely predicated on the reality that changes in morbidity and
mortality in populations are necessarily linked to a whole series of contributive
factors." (Noted authority George Dick states that: "Many infectious diseases
can be prevented without immunization, because once the natural history of the disease is
understood, the source may be eliminated or transmission prevented [e.g.,] . . . . When it
was discovered that cholera and typhoid epidemics were regularly transmitted by faecal
contamination of water, the provision of clean water supplies nearly eradicated these
diseases from many countries without recourse to immunization.")24
It is widely acknowledged that factors such as: nutrition,
sanitation, potable water; the natural and social environments (e.g., agricultural
practices, food supply, education and income), all play vital roles in determining the
onset, severity, and eradication of both infectious and degenerative diseases. Diseases
such as cholera and typhoid, have been strongly linked to water and sanitation, whereas
evidence continues to accumulate that nutrition remains likely the most critical
determinant factor in the full range of infectious and degenerative human diseases.25

The very fact that in this UNICEF project--as in many others--EPI is implemented over a
period of years in the midst of a whole series of other natural and basal socioeconomic
improvement measures, each having their own critical impact on any population's health
status (including epidemicity levels) suggests that EPI could actually be playing a
negligible or even a negative role, and no one would really know the difference.

According to the recently completed comprehensive Program Evaluation of the Canadian
International Immunization Program--Phase 1, this poses a situation in which the
relative impact of expanded immunization programs on mortality levels in the Developing
World remain largely unsubstantiated. To quote: "at present it appears that there is
no conclusive evidence on the impact of immunization on child mortality from all causes .
. . It may be that EPI's effect is merely to bring about "replacement
mortality," whereby children . . . succumb to other diseases instead. The uncertainty
over the impacts of EPI remain a major question in PHC programming."26

In a similar vein, Debabar Banerji, Chairman of the Centre of Social Medicine and
Community Health at Jawaharlal Nehru University raises serious concerns with the UNICEF
sponsored Universal Childhood Immunization program in his own nation. He suggests that:

If we turn to the epidemiological analysis of UCI-90 in India, we are
astonished to learn that such a gigantic program has been launched without having even the
most basic data on infectious diseases . . . Then how will it be possible to determine the
cost-effectiveness of the program? Actually, there ought to have been much more detailed
analysis. . . .

For example, with regard to disease levels and factors, he urges that very basic questions
should have been addressed before implementing UCI, such as: . . . how different are the
rates in different parts of the country and what are the ecological, cultural, social and
other factors which affect the rates--through influencing the balance between the host,
the parasite [i.e., virus or microbe] and the environment. Information should have been
provided on what are the trends in the epidemiological behaviour of the different diseases
over a time period, what should be the epidemiological strategy for intervention in the
natural histories of the diseases, and so on. Paying scant attention to such critical
epidemiological considerations, the crusaders of UCI-90 have opted in favor of saturation
spraying with "silver bullets " [vaccines]. Over and above this, there are also
the important questions of efficacy of the vaccines. . .

Administratively, the exponents of UCI-90 seem to indulge in collective amnesia to wish
the bitter experiences of major vertical [top down] programs like the mass BCG Campaign,
the National Malaria Eradication Program, and the three [national] efforts at eradication
of smallpox . . . Also actively shunned are the many lessons from the failures of vertical
programs for trachoma, leprosy, filariasis, cholera, and sexually transmitted
diseases." 27

Selectively slanted and incomplete reporting of the true statistical picture is not an
infrequent problem in the promotive oriented reporting on EPI impact data. For example,
the following Tables B and C, were based on data presented in Section 4.3 "Expanded
Programme of Immunization," in UNICEF's Fourth Progress Report CUC/CIDA
Development of Basic Services for Children in Thailand, covering the period
January--December, 1988.

Table B -- Immunization Coverage for Measles in Thailand

Year of Coverage

1982

1983

1984

1985

1986

1987

1988

Percentage Immunized

06

26

44

60

63

Table C -- Incidence of measles in Thailand

Year

1982

1983

1984

1985

1986

1987

1988

Number

27,691

34,713

47,205

32,156

19,659

42,051

32,498

Case Rate Per 100,000

(57.1)

(70.2)

(93.7)

(62.2)

(37.1)

(78.1)

59.1)

The following comment is made with respect to the expansion of the measles
vaccination program, ". . . the immunization coverage for measles has increased from
6 percent in 1984 to 63 percent in 1988, leading to a reduction in measles prevalence from
93.7/100,000 in 1984 to 37.1/100,000 in 1986."

What the report fails to indicate though is that although the 1986 inununization coverage
of 44% had increased by 1987 to 60%, the measles infection rate in the same period
actually more than doubled, with an increase from 37.1 to 87.1 per 100,000. It is also
noteworthy that the culminating maximum immunization coverage of 63% achieved in 1988,
correlates with a 1988 infection report rate of 59.1 /100,000--which in fact poses higher
level of measles infection than the 1982 reported infection rate of 57.1 /100,000, which
was a time when measles immunization was not being provided in Thailand. (The higher per
capita infection rate--after five years of expanding coverage--obviously reflects very
negatively on the assumed efficacy of the vaccine, and may have been deliberately
obfuscated in the reporting. No evidence was seen to suggest that the post-immunization
increases in disease rates were attributable to case reporting improvements.)

Clearly, Universal Childhood Immunization stands in contradiction to the strategically
development based primary health care principles as embodied in the Alma Ata Declaration.
(The issue of intersectoral primary health care versus selective medicine remains an area
of major controversy. It will be examined in considerable detail later in this paper). In
fact, Developing World analysts such as D. Banerji, forcefully contend that short term,
"top down" approaches to health care--such as EPI threaten to reverse Alma Ata's
historic gains for more self-directed and sustainable health care. In his view the
shifting emphasis toward selective medicine including UCI/EPI:

Negates the principle of community participation and control as
exemplified in "bottom up" development

Accords resource allocations only to certain target groups, ignoring the
needs of the total family and community

Displays questionable moral and ethical values, in which a questionable
commodity of foreign and elite interests, is promoted to and imposed on the majority of
the people.28

In his own words, the Universal Childhood Immunization initiative,
constitutes the efforts of ruling interests in Donor nations:

. . . to hit out at the very core of the philosophy of primary health
care by imposing technocentric vertical programs against a few diseases in the name of
saving children . . .This movement not only tends to fragment a health care system and
take it away from a wider ecological, intersectoral, and integrated approach, but it also
actively hinders community self-reliance and seriously erodes the democratic rights of the
people to participate in decisions which so vitally concern them. This is perhaps the most
malignant facet of the present efforts to impose specialized . . . programs from outside,
using social marketing techniques to sell them." 29

Researchers like Rifkin and Walt maintain that interventions such as
EPI, are essentially based on the (now fading) view that human health is dependent upon
and arises from a force of elite professionals who hold privileged knowledge--coupled with
corresponding power and control--to effect their disbursal of technocentrically contrived
benefits, to relatively ignorant and passive recipients.30 It goes without saying that any programmed encouragement of this mind
set--despite the very best of intentions--constitutes an inimical force to those
principles and processes whereby intelligent self-development, and informed self-care can
prevail.

Health professionals, by taking and promoting easily executed
interventions, such as immunization, create a demand for these programs and raise
expectations which are seldom realized.. SPHC by identifying specific techniques (such as
EPI) and strongly supporting them, diverts attention and resources from the process of
development, to highlighting specific programs with exaggerated and often unpredictable
outcomes. In reality, technocratic and "instant" successes, put into danger the
long slow process that leads to sustained improvements. They are creating a climate of
short-term expediency, rather than long term change.31

It can well be said that real "ignorance is not knowing, but knowing what isn't
so." The question of whether vaccines in fact protect recipients from the diseases
for which they are given, might seem absurd on the face of it. As already noted, when we
closer examine the question of statistical evidence for immunization's effectiveness,
there remain significant epidemiological uncertainties. The literature further reveals
some critical problems in data gathering, interpretation and reporting practices. These
basic concerns are succinctly summarized by Professor Gordon Stewart, recent head of the
Department of Community Medicine at Glasgow University:

What kind of immunization is this for which success is being
claimed?... What kind of epidemiology is this which advocates immunization b excluding,
consideration of factors other than immunization? . . . "at kind of editorial policy
is this which publishes incomplete data and promotes far reaching claims about the
efficacy of immunization, but refuses to publish collateral data questioning this
efficacy? 32

We are thus confronted with an unenviable situation where in the general
absence of verifiable multifactored and controlled studies, EPI remains
today--scientifically speaking--as a basically unproven program intervention. In fact,
there is a substantive and growing body of data that call into serious question the
soundness and effectiveness of mass immunization programs. This data not only calls into
question EPI effectiveness, but further details adverse side effects and potential long
term dangers of this widely implemented medical intervention.

In order to better grasp the issue of vaccine effectiveness, it would prove helpful for us
to go back to the early theoretical foundation upon which current vaccination and disease
theories originated. In simplest terms, the theory of artificial immunization postulates
that by giving a person a mild form of a disease, via the use of specific foreign
proteins, attenuated viruses, etc., the body will react by producing a lasting protective
response e.g., antibodies, to protect the body if or when the real disease comes along.

This primal theory of disease prevention originated by Paul Ehrlich--from the time of its
inception--has been subject to increasing abandonment by scientists of no small stature.
For example not long after the Ehrlich theory came into vogue, W.H. Manwaring, then
Professor of Bacteriology and Experimental Pathology at Leland Stanford University
observed:

I believe that there is hardly an element of truth in a single one of
the basic hypothesis embodied in this theory. My conviction that there was something
radically wrong with it arose from a consideration of the almost universal failure of
therapeutic methods based on it . . . Twelve years of study with immuno-physical tests
have yielded a mass of experimental evidence contrary to, and irreconcilable with the
Ehrlich theory, and have convinced me that his conception of the origin, nature, and
physiological role of the specific 'antibodies' is erroneous.33

To afford us with a continuing historical perspective of events since
Manwaring's time, we can next turn to the classic work on auto-immunity and disease by Sir
MacFarlane Burnett, which indicates that since the middle of this century the place of
antibodies at the centre stage of immunity to disease has undergone "a striking
demotion." For example, it had become well known that children with
agammaglobulinaemia--who consequently have no capacity to produce antibody--after
contracting measles, (or other zymotic diseases) nonetheless recover with long-lasting
immunity. In his view it was clear "that a variety of other immunological mechanisms
are functioning effectively without benefit of actively produced antibody."34

The kind of research which led to this a broader perspective on the body's immunological
mechanisms included a mid-century British investigation on the relationship of the
incidence of diphtheria to the presence of antibodies. The study concluded that there was
no observable correlation between the antibody count and the incidence of the
disease." "The researchers found people who were highly resistant with extremely
low antibody count, and people who developed the disease who had high antibody counts.35 (According to Don de Savingy of IDRC, the
significance of the role of multiple immunological factors and mechanisms has gained wide
recognition in scientific thinking. [For example, it is now generally held that vaccines
operate by stimulating non-humeral mechanisms, with antibody serving only as an indicator
that a vaccine was given, or that a person was exposed to a particular infectious agent.])

In the early 70's we find an article in the Australian Journal of Medical Technology
by medical virologist B. Allen (of the Australian Laboratory of Microbiology and
Pathology, Brisbane) which reported that although a group of recruits were immunized for
Rubella, and uniformly demonstrated antibodies, 80 percent of the recruits contracted the
disease when later exposed to it. Similar results were demonstrated in a consecutive study
conducted at an institution for the mentally disabled. Allen--in commenting on her
research at a University of Melbourne seminar--stated that "one must wonder whether
the . . . decision to rely on herd immunity might not have to be rethought.36

As we proceed to the early 80s, we find that upon investigating unexpected and
unexplainable outbreaks of acute infection among "immunized" persons, mainstream
scientists have begun to seriously question whether their understanding of what
constitutes reliable immunity is in fact valid. For example, a team of scientist writing
in the New England Journal of Medicine provide evidence for the position that
immunity to disease is a broader bio-ecological question then the factors of artificial
immunization or serology. They summarily concluded: "It is important to stress that
immunity (or its absence) cannot be determined reliable on the basis of history of the
disease, history of immunization, or even history of prior serologic determination.37

Despite these significant shifts in scientific thinking, there has unfortunately been
little actual progress made in terms of undertaking systematically broad research on the
multiple factors which undergird human immunity to disease, and in turn building a system
of prevention that is squarely based upon such findings. It seems ironic that as late as
1988 James must still raise the following basic questions. "Why doesn't medical
research focus on what factors in our environment and in our lives weaken the immune
system? Is this too simple? too ordinary? too undramatic? Or does it threaten too many
vested interests . . ?" 38ARTIFICIALLY INDUCED
IMMUNITY--REALITY OR DELUSION?

Physiologist, S.K. Claunch raises an reasonable postulate when he suggests that the body's
capacity to initiate a "vigorous reaction" (i.e., the acute processes of
elimination associated with viral and infectious diseases) hinges essentially on its level
of vitality, and thus such reactions are most commonly found in children. In contrast, it
is generally acknowledged that the very feeble and or chronically diseased--who have
significantly lower vital energy levels--tend to remain relatively free from such acute
reactions. This observation in turn lead him to express the concept that:

If any child has its vitality lowered and its health impaired to the
degree that it is no longer strong enough to develop an acute disease, it is, for the time
being, at least "immune." This is the exact clinical picture one observes when
serums, vaccines and "biologicals" are shot into a child . . . its vitality is
so lowered that it is no longer healthy enough to protest or react against them. So long
as its vitality stays down, it will be "immune." 39

A number of detractors have legitimately raised the question of how the
injection of foreign disease matter into the human system can constitute a legitimate
approach to the sustenance of human health. After all, we don't seek warmth of icebergs,
is there thus any more logic in seeking health from substances which are intimately
associated with disease and death? The articulate view of physiologist H.M. Shelton is
that:

To interfere with the all-important composition of the blood in the
haphazard manner serologists do, results in incalculable disturbance of its physiological
equilibrium . . . health depends, not upon killing bacteria [& viruses] but upon
building up the soundness . . . integrity [and] functional vigor . . . of our own tissues
and organs. . . . Normal resistance can be achieved only by use of the same means by which
it was originally built and maintained.

Nature makes no mistakes and violates no laws. She is uniformly governed by fixed
principles and all her actions harmonize with ... [nature's governing] laws . . . The
best, indeed the only method ofpromoting public health is to teach people the laws of
nature and.. how to preserve health. Immunization programs are futile, and are based on
the delusion that the law of cause and effect can be annulled Vaccines and serums are
employed as substitutesfor right living; they are intended to supplant obedience to the
laws of life. Such programs are slaps in the face of law and order." 40

In order to provide some further background to the reader, this section will briefly
recount some of the most significant observations of earlier scientists on the broader
question of what is the actual role bacteria and viruses play in human infectious disease.
The debate on this issue--although an old one remains highly relevant and timely in that
the whole edifice of Western selective medicine, both preventive and therapeutic, hinges
upon a correct perspective on and resolution of the question.

Indeed, it remains remarkable that whether we go to recent or more distant history, we
find that fundamentally critical scientific discoveries and observations which serve to
clarify these issues, and point in a more appropriate direction, continue--at least in
practice--to be largely unknown and or ignored. (Some researchers would suggest that this
failure arises because such discoveries--if genuinely applied--would significantly curb
what amounts to annual income totaling multiple billions of dollars in the exploitation of
human disease.) However, it is apparent that the factors underlying this failure are in
reality much broader and more complex.

Due to the need for brevity, only two cases of historic significance will be considered.
Earlier in this century, C.E. Rosenow of the Mayo Biological Laboratories began a series
of experiments in which he took distinctive bacterial strains from a number of different
disease sources and placed them in one culture of uniform media. In time the distinctive
strains all became one class. By repeatedly changing cultures, he could individually
modify bacterial strains making them some harmless or "pathogenic" and in turn
reverse the process. He concluded that the critical factor allowing demonstration of the
polymorphic nature of bacteria was their environment and the food they lived upon. These
discoveries were first published in the year 1914 in the Journal of Infectious
Disease."41

Rosenow's work was corroborated and expanded upon about two decades later by R.R. Rife,
developer of the Universal Microscope which was developed concurrent with RCA's initial
marketing of the electron microscope. Rife's alternative was a 5,682 component, 150,000
power (60,000 diameters of magnification) instrument which made live bacteria visibly
"clear as a cat on your lap." This microscope was a light transmitting
instrument with a resolution of 31,000 diameters (traditionally electron microscopes had
resolutions of up to 25,000 diameters) which overcame the chief weakness of the electron
scope, i.e., the inability to view living cells structures and bacterial and viral
organisms in their unaltered living state.(An alternative was required, as living matter
when viewed under the electron scope, becomes altered and distorted due to bombardment by
a virtual hailstorm of electrons, with such distortions increasing proportionally with the
intensity of magnification. Consequently, the extremely high magnification levels found in
the latest electron microscopes actually serve to exacerbate this major flaw.)

Modern microscopy texts suggest that with light microscopes it is impossible to obtain
extremely high magnifications of objects and still retain visual clarity. For example
Novikoff and Holtzman affirm that in such instruments a point is reached after which the
image is "increasingly blurred and nothing is gained by further magnification. Thus,
light microscopes are rarely used at magnifications greater than . . . 1500 X." 42

However, Rife's invention with its 14 separate crystal quartz lenses and prisms, was able
to bend and to polarize light in such a way that a specimen could be illuminated by
extremely narrow portions of the spectra, and even by a single light frequency. This
combined with the shortening of projection distance between prisms, and other innovative
technical features permitted high resolutions without distortion at extremely high
magnifications, never before or since attained in light microscopy.43

Rife showed that by altering the environment and food supply, friendly bacteria such as
colon bacillus could be converted into varied "pathogenic" bacteria.
For example, Rife also observed that bacillus coli could in timebe modified into the bacterial agent associated with typhus, and theprocess actually reversed. In Rife's words:

In reality, it is not the bacteria themselves that produce the
disease, but we believe it is . . . the unbalanced cell metabolism of the human body that
in actuality produce the of disease. We also believe if the metabolism of the human body
is perfectly balanced . . . it is susceptible to no disease.44

This observation closely parallels Alexis Carrel's earlier research at
the Rockefeller Institute where he was able to control the rates and levels of infectious
disease mortality among mice. Beginning with the standard diet he observed a corresponding
death rate of 52 percent. By making specific dietary improvements he was able to reduce
mortality rates downward to 32 percent, then 14 percent, and finally to a rate of 0.45

Not too long after Rife's and Carrel's reported observations, scientist Rene Dubos (also
at the Rockefeller Institute) reaffirmed their open and direct challenge to the
conventional thinking and practice of the scientific community at large. He suggested that
the presumed relationship between microbes and the onset of human disease has been
"so oversimplified that it rarely fits the facts of disease. Indeed it corresponds
almost to a cult . . . undisturbed by inconsistencies and not too exacting about
evidence." He expanded upon this view in suggesting that we need to objectively
account for the fact that extremely virulent:

. . . pathogenic agents [i.e., bacterial and viral micro-organisms]
sometimes can persist in the tissues without causing disease, and at other times can cause
disease even in the presence of specific antibodies. We need also to explain why microbes
supposed to be non-pathogenic often start proliferating in an unrestrained manner if the
body's normal physiology is upset. . . .

During the first phase of the germ theory the property was regarded as lying solely within
the microbes themselves. Now virulence is coming to be thought of as ecological . . . This
ecological concept is not merely an intellectual game; it is essential to a proper
formulation of the problem of microbial diseases and even to their control " 46

Indeed, Dubos--in time--came to voice the conclusion that "Viruses
and bacteria are not the cause of disease, there is something else." In his classic
work Mirage of Health, he states "The world is obsessed by the fact that
poliomyelitis can kill and maim . . . unfortunate victims every year. But more
extraordinary is the fact that millions upon millions of young children become infected by
polio virus, yet suffer no harm from the infection."47 This view closely corresponds to the oft quoted conclusion arrived at in later
life by R. Virchow (popularly reputed as father of the "germ theory") when he
stated, "If I could live my life over again, I would devote it to proving that germs
seek their natural habitat, diseased tissues, rather than being the cause of
disease."

Since Dubos' time, researchers have estimated that the quantity of symptom free exposure
to viruses out number clinical illnesses by at least one hundred-fold.48 This conclusion is based on the "high
proportion of adults who have virus-neutralizing substances in their serum and the number
who, during an epidemic, excrete virus without becoming ill.49

Further corroborative conclusions have been recently reached by some prominent scientists
in their critical examination of the popular view that Human Immuno-deficiency Virus (HIV)
is the key, if not the singular cause of the Acquired Immuno-deficiency Syndrome (AIDS).
Evidence is in that the popularized view that HIV causes AIDS is far more a political
necessity, than a genuine scientific conclusion. (Although the observed action and effects
of viruses, and retroviruses--such as HIV--do in fact significantly differ, what is being
called into question is the validity of labeling microbes--of whatever form--as the key
and or sole "cause" for disease, or as in this case of acquired
immunodeficiency.)

Peter Duesberg (Professor of Molecular Biology at the University of Calif.- Berkeley;
considered by many to be the world's leading expert on retroviruses; and Nobel Prize
candidate for his work in discovering oncogenes in viruses) provides compelling evidence
that lifestyle based factors serve as the primal determinants in the evolution of the 20
plus neoplastic and degenerative diseases that are now associated with AIDS. Employing his
own research--complemented by 196 cited references--an article entitled "HIV and
AlDs: Correlation but not causation," was published in 1989 in the Proceedings of
the National Academy of Sciences USA. This article indicates that "Free" HIV
virus (Free meaning that the retrovirus is already part of the genome) is not detectable
in most cases of AIDS;" "Pure HIV does not cause AIDS upon experimental
infection of chimpanzees or accidental infection of healthy humans;" and
"Epidemiological surveys indicate that the annual incidence of AIDS [to be understood
as a condition symptomized by various secondary infections for which natural immunity has
been lost] depends critically on non-viral [related] risk factors . . . defined by
lifestyle, health, and country of residence."

In an interview published nearly five years later Dr. Duesberg is more convinced than ever
that the HIV retrovirus is not the cause of AIDS, or of the mortality associated with
AIDS. Some of the key points he makes in this important interview follow:

There are roughly seven and a half million people world wide who are
known carriers of HIV, and who continue to remain free of the immune deficiency symptoms
associated with AIDS, and there's not one authenticated case "where you get infected
today and get a disease. . . years later . . . infectious agents work immediately or
never."

HIV has been found to be totally absent in the system
of over 4,600 persons diagnosed with AIDS, so to save political face the US Centers for
Disease Control have been forced of late to give such cases a new name i.e.,
"idiopathic CD 4 Iymphocytopenia."

There are a million Americans with HIV and their T cells are normal,
indeed, "HIV is one of the most harmless viruses you could possibly have. It never
claims more than one in 1,000 cells every other day" during which time your body
replaces "at least 30 out of 1,000" cells.

AIDS is not an infectious disease, but rather arises from "party
swinger lifestyles" that includes: the widespread and abundant use of various immune-
depleting drugs both legal and illegal such as cocaine, alcohol, marijuana, amphetamines,
aphrodisiacs, amyl or butyl nitrites (poppers), combined with correlated conditions of
malnutrition, inadequate sleep, and poor hygiene.

Another key cause of AIDS and the mortality arising from it is medical
treatment in itself, viz. AZT has become "AIDS by prescription" and design. In
other words in the US alone 200,000 persons (most of whom have normal health) who've
tested positive for HIV antibodies, are given 250 mg of AZT every six hours. This highly
toxic drug destroys bone marrow, as well as red blood cells thus precipitating cellular
oxygen starvation destroys white blood cells; causes anemia, weight loss, muscle loss,
nausea, and worsening immune system deficiency coupled with the ensuing infectious
diseases commonly associated with AIDS, and finally death. (The very same sequence of
rapid physiological deterioration, immune deficiency and infections has been documented in
healthy persons who were tested positive for HIV, and quickly submitted to medical
treatment, but were later confirmed as false positives.)50

Bio medical scientist and AIDS researcher Joseph Sonnabend speaks of
". . . the failure of our scientific and medical institutions to have provided an
even rudimentary understanding of the pathogenesis of this disease in the eight years
since its first description, let alone to have developed interventions...that might
significantly alter its course." His well researched conclusions include the view
that "The association of HIV seropositivity with AIDS could . . . derive from the
possibility that the expression of HIV (and consequent seroconversion) is an effect,
rather than a cause of AIDS. . ."51

In summary, if we retum to Robert Koch's 19th century postulates of the "Germ
Theory," viz. in order to cause disease particular "bacterium:" a) must be
found in every case of the disease; b) must never be found apart from the disease; and c)
must consistently produce the same disease as that manifested by the body from which the
disease related germs were taken; we find that in reality each postulate has been
disproved time and again by varied experience and experimental data.52

Nonetheless, it appears that to this day there remains only a marginal acknowledgment or
practical recognition that it is the condition of the body-mind complex and its internal
and external environments, which are the principal determinants of the nature, prevalence
and role of bacteria, viruses, and even retroviruses.

As a result of the re discovery of many of these earlier scientific investigations, as
well as more recent observations in molecular biology, there has arisen among more
independent scientists and primary health practitioners a new concept that has been coined
as the cellular theory of infectious disease. This seemingly more logical and updated
view, poses a serious challenge to the present unquestioned emphasis on supporting mass
selective medicine approaches (including artificial immunization) in the Developing World.

The traditional Bacterial--Viral and the emerging Cellular--Ecological theories of disease
are contrasted in the table which follows. The practical acceptance of the cellular theory
as delineated would entail a substantive shift away from both preventive and therapeutic
interventions which are heavily predicated on Western selective medicine, i.e., vaccines
and drugs, and toward fundamental health improvement measures such as sound nutrition,
potable water, sanitation and overall enhancement of the human physical and social
environments.53

1. The evolution of and susceptibility to disease arises from
conditions arising within the cells of the body.

2. As the primary cause of disease, micro-organisms are generally
considered as vicious, needing to be destroyed.

2. These micro-organisms are primarily endogenousto more complex
living organisms and normally function to assist the life sustaining and/or metabolic
processes of such bodies.

3. The appearance and function of specific micro-organisms is
constant.

3. The appearance and function of these micro-organisms undergo
pathogenic changes when the host organism is weakened or injured, which injury may be
mechanicallly, biochemically or emotionally induced.

4. Every disease is associated with a particular micro-organism.

Every disease is asssociated with particular factors and
conditions.

5. Micro-organisms are primary causal agents.

5. Micro-organisms become pathogenic, i.e., associated with
disease, only when the integral health of the body deteriorates. Hence, psycho-physical
integrity is of first importance, as it constitutes the key factor in the prevention, or
the remediation of human disease in all its forms.

7. To prevent and cure disease, it is necessary to war upon
pathogenic micro-organisms (using toxic aqnd pathogenic weaponry) that as well, destroys
the health of the body-mind complex.

7. To prevent or cure all forms of disease, one need only to ensure
that the primal requisites of health ore met, which includes sysstematic compliance with
natural physical, psychological, and spiritual law.

In that major declines in infectious disease took place before the advent of specific
vaccines and antibiotics, scientists and or physicians such as Dubos, Dettman, Illich,
McCormick, Taylor, Buttram, and Hoffman agree that the overall eradication of varied
infectious diseases were due to basic improvements in nutrition, sanitation, housing,
education and related socioeconomic conditions. Forexample, Canadian physician
W.J. McCormick was able to make this telling observation at
midpoint in the present century.

The usual explanation offered for this changed trend in infectious
diseases has been the forward March of medicine in prophylaxis and therapy; but, from a
study of the literature, it is evident that these changes in incidence and mortality have
been neither synchronous with nor proportionate to such measures . . .

. . . . the decline in diphtheria, whooping cough and typhoid fever began fully fifty
years prior to the inception of artificial immunization and followed an almost even grade
before and after the adoption of these control measures. In the case of scarlet fever,
mumps, measles and rheumatic fever there has been no specific innovation in control
measures, yet these also have followed the same general pattern in incidence decline.54

Span several decades--with some going back to the mid-nineteenth century--and reveal the
evidence upon which McCormack's observation is based.

Tables XI & XII

Provide more recent data which suggest the apparent failure of Expanded Programs of
Immunization in the reversal and prevention of whooping cough (pertussis) and diphtheria
in Nigeria, with notable increases in these diseases occurring soon after implementation
of widespread immunization (tables in the source article for measles, polio and tetanus,
although not included, each suggest that the impact of EPI was negligible).

Tables XIll--XVIII

Represents the period of a decade in the Dominican Republic (a visually parallel
micro-cosm to the longer decline periods exhibited in the Western world) where there
occurred a general pattern of significant multiple infectious disease declines--prior to
the advent of expanded immunization--with a general pattern of moderate increases in
various disease levels occurring soon after full implementation of specific immunization
interventions, followed by a return to the earlier decline pattern.

FURTHER BACKGROUND NOTES ON TABLES

It is a rarely excepted rule that when increases and or decreases in
disease specific mortality occur, there will be corresponding changes in morbidity, (e.g.,
see parallel death, and case bar lines on tetanus and tuberculosis in Canadian
Immunization Guide, 3rd
Edition, 1989).

The only tables which are not essentially visual reproductions of tables
found in the documented "Source References," are Tables XIII- XVIII. The reason
follows: In reviewing a series of 6 UNICEF evaluation studies (Evaluation Pub. No's 1-6)
on EPI efforts throughout the 1980's in Nigeria, Burkino Faso, Turkey, Cameroon, Senegal,
and the Dominican Republic, only Pub. No. 6 on the Dominican Republic provided sufficient
epidemiological data to permit the drawing of any definite conclusions on EPI impacts.
Because EPI intervention data was not included in the evaluation report's morbidity
tables, original tables were prepared.

The designation "natural decline," simply indicates infectious
disease declines free from adventitious immuno-prophylaxes. As in the West, significant
and enduring non-artificial immunization factored declines have occurred in the Developing
World. This has occurred despite what are considered to be normal cyclical down and
up-swings in infectious disease levels.

Table 1: Deaths of Children Under 15 Years (England & Wales)

Table I--shows that in England and Wales there was a 90 percent decline in child mortality
from the combined infectious diseases of scarlet fever, diptheria, whooping cough, and
measles in the period of 1850 to 1940. The first vaccine made available was for
Diptheria
in the early 40's, whereas the pertussis (whooping cough) vaccine became available in the
early 50's and the measles vaccine in the late 60's (no vaccine was provided for scarlet
fever).55

Table II: Whooping Cough (England & Wales)

Table II--indicates that in England and Wales the annual death rate of
children (under age 15) from whooping cough declined by roughly 98.5 percent in the period
covering 1868 to 1953, after which the pertussis vaccine became generally available.56

Table III: Measles (England & Wales)

Table III--shows that in England and Wales the annual death rate of
children (under age 15) from measles declined from over 1,100 per million in the
mid-neneteenth century, to a level of virtually 0, by the mid 1960's.57

Table IV: Smallpox (England & Wales)

Table IV--reveals that in England and Wales there was a continuing
decline in the annual death rate from smallpox, with a reduction in mortality of roughly
300 per million to virtually 0, taking place in the 60 year period following the middle of
the last century. This table further illustrates that the progressive rate of decline was
severely disrupted--with a roughly 275 percent increase in mortality from the
disease--occurring immediately after smallpox vaccination laws were enforced.58

Table V: Infant Mortality Rate (Australia)

Table V--Indicates that in Australia, approximately two thirds of the total decline in
infant deaths from all childhood infectious diseases, in the period covering 1881 to 1971,
occurred before the introduction of mass immunization offorts.59

Table VI: Declining Death Rates (US)

Table VI--reveals that in the United States--without benefit of any
vaccine--the tuberculosis mortality rate underwent a drop of roughly 96 percent in the
first 60 years of this century; and that in a little short of the same time span (although
the effectiveness of the vaccine has been seriously questioned by reputed scientists)
mortality from typhoid vanished.60

Table Vll: Declining Death Rates (England)

Table VII--shows that in England death rates from respiratory
tuberculosis underwent a roughly 87 percent decline in the period beginning 1855 and
ending in 1947, when antibiotics first came into wide use; and a further decline
approximating 93 percent by 1953, preceedin the introduction of the BCG vaccine.61

Table Vlll: Number of Countries Reporting Smallpox

Table VIII--reveals, in the 17 year period preceeding the WHO Smallpox
Eradication Program, a progressive drop to nearly one half, in the number of countries
reporting smallpox morbidity.62

Table IX: Acute Rheumatic Fever Death Rates (Britain)

Table IX--indicates that in Britain, the annual death rate from rheumatic fever underwent
a decline approximating 86 percent in the period covering 1850 to 1946, before penicillin
had become available.63

Table X: Scarlet Fever Death Rate (England &
Wales)

Table X--reveals that in the period of 1865 to 1935, before sulfonamides
had become available in England and Wales, the annual death rate from scarlet fever
declined by approximately 96 percent.64

Table XI: Diphtheria (Nigeria)

Table XI--shows that following a significant increase in the diptheria morbidity rate
which Peaked in 1977, the disease underwent two years of rapid natural decline--equivalent
to 73.5 percent--in the number of cases, with such decline occurring prior to the
immplementation of EPI in 1979. This decline pattern continued during implementation of
EPI to 1980, after which--by 1982--the incidence of diptheria exhibited a major increase
of nearly 30 fold.65

Table XII: Whooping Cough (Nigeria)

Table XII--shows that a significant increase in the whooping cough
morbidity rate (1973 to 1974), was followed by a sharp natural decline from 1974 to 1975
equivalent to 91 percent. The very slight incline which followed up to 1979--when EPI was
introduced--still posed an 86.5 percent lower morbidity level than in 1974. Post EPI data
indicate a short lived slight decline, followed by an increase in morbidity of 34 percent
over the ensuring two years.66

Table XIII: Poliomyelitis (Dominican Republic)

Table XIII--reveals that in the period of 1980 to mid 1983--before implementation of EPI
the poliomyelitis morbidity rate underwent a natural decline equivalent to 98.5 percent to
wheat is practically an eradication level of only 1 per million. EPI was followed by a
continuing natural decline to zero, however the incidence of poliomyelitis then underwent
a minor increase for two years, and gradually returned to a zero level in 1980.67

Table XIV: Measles (Dominican Republic)

Table XIV--indicates that in the period of 1980 to late 1985--before implementation of EPI
the measles morbidity rate underwent a natural decline equivalent to 88 percent. Upon
introduction of EPI in late 1985, the natural decline continued for a brief period, halted
and then measles more than doubled from its 1986 and 1987 levels.68

Table XV: Diphtheria (Dominican Republic)

Table XV--shows that in the period of 1978 to mid 1985--before implementation of EPI--the
diptheria morbidity rate underwent a natural decline equivalent to 81.5 percent. Upon
introduction of EPI in mid 1985, the natural decline continued for a brief period, and
then by 1987 the diptheria case rate more than doubled from its 1986 level. The disease
than returned to its natural rate of decline, proceeding to a very low level in 1989.69

Table XVI: Pertussis (Dominican Republic)

Table XVI--reveals that in the period of 1978 to mid 1985--before
implementation of EPI the pertussis (whooping cough) morbidity rate underwent a natural
decline equivalent to 84.5 percent. Upon introduction of EPI in mid 1985, there was a
slight rise and then return to the earlier natural decline pattern reaching its lowest
level by 1988. However, by 1989 the pertussis morbidity rate nearly tripled from its 1988
level.70

Table XVII: Tetanus (Dominican Republic)

Table XVII--indicates that in the period of 1979 to mid 1985--before implementation of EPI
the tetanus morbidity rate underwent a natural decline equivalent to 74 percent. Upon
introduction of EPI in mid 1985, the natural rate of decline continued for a brief period
to 1986. However, by 1988 the incidence of tetanus had more than tripled from its 1986
level, and then by 1988 returned to its earlier natural decline pattern, reaching a level
in 1989 still higher than its 1986 level.71

Table XVIII: Neonatal Tetanus (Dominican Republic)

Table XVIII--shows that in the period of 1978 to the end of 1985--before
the implementation of EPI (tetanus toxoid for expectant mothers)--the neonatal tetanus
morbidity rate underwent a natural decline equivalent to 98.5 percent. Upon introduction
of EPI in late 1985, the natural rate of decline continued for a brief period to 1987.
However by 1988 the incidence of neonatal tetanus had increased by nearly five fold over
its 1987 rate, and then by 1989 declined to a level still higher than it was in 1986.72

Ekanem's earlier noted research (Table XI), reveals an increase of 215 percent in the
number of diphtheria cases by the end of the three year period following implementation of
UNICEF's Expanded Program of Immunization. Robert Mendelsohn (Assoc. Prof. of Preventive
Medicine and Community Health, University of Illinois) reports "that children who
have been immunized [for diphtheria] fare no better than those who have not." He went
on to describe an outbreak of diphtheria in which "fourteen of twenty-three carriers
had been fully immunized." This means that just over 60 percent of the carriers who
were presumed to be protected by the toxoid, contracted the disease. In his words
"Episodes such as these shatter the argument that immunization can be credited with
eliminating diphtheria or any of the other . . . childhood diseases."73

The following conclusion is extracted from the Minutes of the 15th Session (November
20-21, 1975) of the Panel of Review of Bacterial Vaccines and Toxoids with Standards
and Potency (data presented by the US Bureau of Biologics, and the Food and Drug
Administration).

For several reasons, diphtheria toxoid, fluid or absorbed, is not as
effective an immunizing agent as might be anticipated. Clinical (symptomatic) diphtheria
may occur . . . in immunized individuals--even those whose immunization is reported as
complete by recommended regimes . . . the permanence of immunity induced by the toxoid . .
. is open to question.74

Earlier historical data on protective toxoiding efforts in N. America clearly verify not
only the FDA's conclusion, but the fact that the toxoid actually exacerbated the
seriousness of the disease. North American data on various diphtheria outbreaks in the
early 40's, reveal the following facts.

In the Halifax Canada epidemic, of the cases admitted for hospital
treatment, 66 had previously received one or more doses of diphtheria toxoid or antitoxin,
or were found Shick negative. In fact, of this number five cases had been immunized within
the preceding two month period.75

In the Ottawa Canada epidemic, of 99 cases (all under the age of 15), 36
were found to have previously received all three doses of the toxoid.76

In the Baltimore USA epidemic, 63 percent of all cases had a record or
history of prior immunization with toxoid. Among the fatal and more serious
"Bull-neck" cases, 77.8 percent had previously been toxoided.77

During roughly the same historic period, we find in various European
countries a gripping picture suggesting that the use of Diphtheria toxoid in fact
precipitated epidemics of the disease.77

Throughout 1941 to 1944 "The Ministry and Dept. of Health, Scotland,
admitted almost 23,000 cases of diphtheria in immunized children," with 180
fatalities.78

By the year 1941, the majority of children in France had been inoculated
for diphtheria, the case rate standing at 13,795 by the end of that year. Mass
immunization efforts continued, and "by 1943, the diphtheria cases were more than
tripled to 46,750."79

Diphtheria increased by 55 percent in Hungary and tripled in Geneva,
Switzerland after the introduction of compulsory immunization laws. In Germany, with
compulsory mass immunization "introduced in 1940, the number of cases increased from
40,000 per year to 250,000 by 1945, virtually all among immunized children." Norway,
during the same time frame--just noted--remained unvaccinated, and had only 50 recorded
cases of diphtheria. 80

According to Coumoyer's research, official US Military records show that
enlisted men and women who are thoroughly vaccinated--manifest a morbidity and mortality
rate from diphtheria four times higher, than that of unvaccinated civilians.82

As already noted earlier in this report, the national per capita case rate in Thailand for
measles in 1982, 2 years before the advent of the Expanded Programme of Immunization, was
lower than in the year 1988, i.e., 5 years after implementation of EPI. Per Ekanem's
earlier cited research, the national per capita case rate in Nigeria for measles in 1973,
6 years before the advent of UNICEF's Expanded Programme of Immunization, was lower than
in the year 1982, i.e., 3 years after implementation of EPI.83

The University of Alberta initiated special research on the question of measles immunity,
as a result of a measles epidemic which "swept" the University campus in 1987,
despite a "98 percent immunization rate." The research team's head immunologist
R. Marusyk (who is also affiliated with the Alberta Provincial Public Health Laboratory)
has subsequently confirmed that it is an invalid assumption that vaccination programs for
measles--which are normally administered at 9 to 12 months, and a later childhood booster
shot--confers lifelong immunity. One of their findings indicated that 93 percent of
infants "who were studied" showed no immunity by the age of six months. The
mothers of the 120 babies had all been vaccinated. Normally, antibodies that have been
transferred at birth from the mother to the child remain present for a year."84 (According to D. de Saving at IDRC, this
transfer and retention of antibodies apparently occurs when the mother has had an actual
measles infection, and not just vaccination.)

Similar to the experience at the University of Alberta, the National Geographic in
its January 1991 issue article "The Disease Detectives," refers to a 1988
measles epidemic at Fort Lewis College, Durango, Colorado USA in these words:
"Surprisingly most who fell ill had been vaccinated. CDC (US Center for Disease
Control) investigators rushed to the campus during the 1988 outbreak to trace what had
gone wrong."

There are repeated reports of measles epidemics occurring in fully vaccinated populations.
These failures have occurred repeatedly since the vaccines introduction.85 Other documented research findings follow:

A survey conducted in 1978--covering 30 states in the US--revealed that
"more than half of the children who contracted measles had been adequately
vaccinated;"86

Moskowitz et al. found that in those states with comprehensive (k-grade
12) immunization requirements, between 61 and 90 percent of measles cases occur in persons
who received the recommended vaccines;87 and

A review of 1,600 cases of measles in Quebec, Canada in the period of
January to May of 1989, revealed that 5 8 percent of school-age cases had been previously
vaccinated.88

According to an unpublished WHO research study comparing what would be
defined as a "measles susceptible" group of children, to a control group that
had been immunized for measles, it was observed that the non-immunized group manifested a
normal contraction rate of 2.4 percent, whereas the immunized group exhibited a 33.5
percent contraction level. This implies a 15 times greater likelihood of infection by the
immunized.89 (The researchers
responded to these results with the comment that the vaccine must have been mishandled, or
perhaps the vaccine used was badly manufactured.)

It is of interest that there is an emerging body of mathematically based epidemiological
research which suggests practicable problems with EPI efforts in the control and
eradication of measles in the Developing World. For example, P. Kenya observes that:

Horizontal mass immunization campaigns at regular intervals may be
impractical in terms of costs and operational logistics. . . . In spite of high measles
immunization coverages, measles epidemics are often reported, not only in the less
developed regions but also in those developed countries with measles elimination targets.90

An article in a major consumer journal titled "Twentieth-century miraclemaker,"
in extolling the value of Salk's polio vaccine, indicated that in 1953, there were 15,600
cases of paralytic polio in the United States; by 1957, due to the vaccine, this number
dropped to 2,499." Since this popular conception persists to this day as an important
demonstration of the effectiveness of vaccination procedures in general, and the polio
vaccine in particular, it bears some re-examination.

Bernard Greenberg (late Dean--School of Public Health, University of N. Carolina)
who--during the polio epidemics of the 50's--chaired the Committee on Evaluation and
Standards for the American Public Health Association, submitted testimony to the
Congressional Hearings on polio vaccines (HR0541, 1962). His evidence respecting
diagnostic modifications and statistical manipulation, seriously challenged the popularly
promoted view that the epidemics subsided as a result of vaccine intervention. In his
words "As a result of . . . changes in both diagnosis and diagnostic methods, the
rates of paralytic poliomyelitis plummeted from the early 1950's to a low in 1957."
This involved:

redefinition of what constitutes an epidemic

redefinition of the disease; and

mislabelling, and later reclassification (prior to 1954 "large
numbers" of presumed "paralytic polio" cases were actually "Coxsackie
. . . and aseptic meningitis," statistical reclassification of "polio"
cases (not leading to permanent paralysis) in the ensuing 4 year period became the norm in
virtually all regions of the country.

It is of further interest that Greenberg testified that after the
introduction of much more intensive and frequently compulsory immunization
programs--beginning in 1957--there was a correspondingly substantial increase in polio
cases (which were presumably paralytic, due to the aforenoted reclassification process).
In the period of 1957-1958 there was a 50 percent increase, and 1958-1959 an 80 percent
increase in such cases. He also indicated that during this period statistics were
manipulated and statements made by the US Public Health service, to give an opposite
impression.92

A distinguished interdisciplinary medical panel moderated at the 120th Annual Meeting of the Illinois State Medical Society, confirmed that in the year
1959, roughly 1,000 cases of paralytic polio occurred in persons who had previously
received multiple doses of the Salk vaccine. As a panel member,
B. Greenberg contributed the following observation:

One of the most obvious pieces of misinformation . . . is that the 50
percent rise in paralytic poliomyelitis in 1958, and the real accelerated increase in 1959
have been caused by persons failing to be vaccinated This represents . . . an
unwillingness to face facts and to evaluate the true effectiveness of the Salk vaccine. .
. . A scientific examination of the data and the manner in which the data were
manipulated, will reveal that the true effectiveness of the present Salk vaccine is
unknown and greatly overrated.93

When pediatrician R. Mendelsohn, was asked whether polio would return if
vaccinations were stopped, he replied "Doctors admit that forty percent of our
population is not immunized against polio. So where is polio? Diseases are like fashions,
they come and go . . ." Later on US National television he referred to
epidemiological records which revealed the disappearance of polio in Europe during the
40's and 50's, without benefit of immunizations.94

Speaking at an international health convention in 1978, A. Burton reported that
statistical data compiled by the University of New South Wales in Australia revealed that
polio immunization programs had no measurable impact in reversing what was a recent
epidemic in that country. He expressed the view that polio comes in cycles anyway, and
when it does subside, it is inadvertently considered "conquered" by vaccines.95 This naturally occurring cycle in polio
epidemics was well illustrated in Great Britain where polio peaked in 1950, and had
declined by 82 percent by the year 1956, at which time the vaccine was first introduced.96

Returning to the earlier cited US Congressional Hearings (HR 1054), we find that
the nation of Israel experienced a major "type I" polio epidemic in 1958. Mass
polio immunization had already been enforced and there was no appreciable difference in
contraction levels between the vaccinated and unvaccinated. Additionally, 3 years later in
1961, the state of Massachusetts experienced a "type II" polio outbreak in which
"there were more paralytic cases in the triple vaccinates than in the
unvaccinated".97

It is noteworthy that in one of the few double blind trials that have been conducted on a
vaccine, was for the Salk polio vaccine, in which trial over 200 individuals who received
the vaccine went on to contract polio, whereas no observed polio cases developed amongst
the controls. This trial was reported by Mendelsohn who in the same 1984 article wrote:

The evidence points to mass inoculation against polio as the cause of
most remaining cases of the disease . . . there is an ongoing debate among the
immunologists regarding the . . . killed virus vs. live virus vaccine. Supporters of the
killed virus vaccine maintain that it is the presence of live virus organisms in the other
product that is responsible for thepolio cases that . . . appear. Supporters of the live
virus type argue that the killed virus vaccine offers inadequate protection and actually
increases the susceptibility (to polio) of those vaccinated. . . . I believe that both
factions are right, and that use of either of the vaccines will increase not diminish the
possibility that your child will contract the disease.98

Thirteen scientists recently concluded that: vaccine failures in the major Oman polio
epidemic could not be explained by failures in the cold chain, nor on suboptimum vaccine
potency; the efficacy of OPV in inducing "humoral immunity" was lower than
expected; and primary reliance on routine polio immunization may be "inadequate"
to achieve the goal of eradicating polio by the year 2000. (They also noted similar
paralytic polio epidemics in other highly vaccinated populations,99 e.g., the Gambia, Brazil, and Taiwan.)

V. Fulginiti, Chairman of the American Academy of Paediatrics Committee on Infectious
Diseases made this incisive observation:

Despite more than 30 years of experience with pertussis immunization,
the reasons for recovery from the acute infection and subsequent immunity, are still
uncertain. It is known that second attacks are rare following natural disease. It is also
known that 45-95% of recipients of pertussis vaccine are susceptible to pertussis up to 12
years later . . . we do not understand the immunologic mechanisms involved in resistance
to infection after natural disease or immunization.

Is pertussis vaccine effective? . . . prior to the widespread use ofpertussis vaccine,
both the incidence of pertussis and the case-fatality ratio declined. A 50-fold reduction
in incidence and an 84% reduction in case-fatality were recorded in Great Britain in the
years between 1947 and 1972. . . . In England, protection provided by vaccines prior to
1968 was meager; no greater than 20% protection was noted. . . . Britain is in the
position of advocating use of a vaccine for which there are not hard data.100

G.T. Stewart's observations as published in the British Medical
Journal indicated that "of 8,092 cases of whooping cough, 2,940 (36%) were fully
immunized, while only 2,424 (30%) were definitely not immunized."101

A Medical Tribune Report (January 10, 1979) details an outbreak of whooping cough
in which 46 out of 85 fully immunized children contracted the disease.102 (the reason that the other 39 did not
contract the disease could have been related to any number of predisposing factors).

Ekanem's earlier noted research (Table IX) , reveals an increase of 21 percent in the
number whooping cough cases by the end of the three year period following implementation
of an Expanded Program of Immunization in Nigeria.103

Neustaedter indicates that "Tetanus seems to be nearly eliminated from the United
States, primarily because of good hygiene and proper wound management." His research
suggests that in the period of 1982-1984 in the US, there were a total of nine tetanus
cases among both children and adolescents, in which there were no deaths.104 Whereas Coumoyer's research points to
"contaminated umbilical stump infections" as a principal cause of tetanus in the
Developing World.105 Such
infections can be effectively rectified through providing appropriate information and
training to traditional birth attendants.

Both Cournoyer and Johnson indicate that there have been some reports of lock jaw death in
properly inoculated individuals.106 & 107 Additionally Cournoyer suggests that "Evidence in support of the (tetanus
toxoid) vaccine comes from epidemiologic studies which are by nature controversial, and
which do not satisfy the criteria for scientific proof.108

According to the data contained in Table XVII, in the Dominican Republic the incidence of
tetanus among children actually increased in the two year period following administration
of tetanus toxoid. Table XVIII indicates that in the same country, the rate of neonatal
tetanus--among mothers underwent an increase in the year following administration of
tetanus toxoid.109

Although smallpox is apparently now accorded to the history books, it will be necessary to
re-examine the issue of this disease having been universally eradicated, with particular
reference to the WHO eradication campaign. An honest look at this question is of
considerable importance, as the current worldwide UCI-EPI program gains much of its
legitimacy and inspiration from this widely acclaimed success story.

A strong challenge to this now popular view, is reflected in the post-campaign findings of
medical researchers like Buttram and Hoffman:

Most people probably credit the smallpox vaccine with playing the
major role in recent eradication of smallpox throughout the world, but let us examine the
facts. In the article 'Vaccines a Future in Question,' statistics showed that less than 10
percent of children in developing countries have received vaccines.

They went on to comment that with this level of coverage, the WHO
campaign was not a real factor in the eradication. Data obtained in their broad based
research also led them to conclude that "mass smallpox vaccination was not necessary
for the eradication of smallpox.110

In further examining this question from a longer historical perspective, it became readily
apparent that the WHO claim did not at all square with the earlier data, i.e., historical
smallpox eradication efforts. If we go back as far as the last century, we discover that
Creighton's independent research findings as published in the Ninth Edition of the
Encyclopedia Britannica, strongly contradict the effectiveness of mass smallpox
immunization programs. A few revealing excerpts follow:

. . . in Bavaria in 1871 of 30,742 cases 29,429 were in vaccinated
persons, or 95.7 percent.

Notwithstanding the fact that Prussia was the best re-vaccinated country
in Europe, its mortality from smallpox in the epidemic of 1871 was higher (69,839) than
any other Northern state.

According to a competent statistician (A. Vogt), the death-rate from
smallpox in the German army, in which all recruits are re-vaccinated, was 60 percent more
than among the civil population of the same age . . . although re-vaccination is not
obligatory among the latter.

It is often alleged that the unvaccinated are so much inflammable
material in the midst of the community, and that smallpox begins among them and gathers
force so that it sweeps even the vaccinated before it. Inquiry into the facts has shown
that at Cologne in 1870 the first unvaccinated person attacked by smallpox was the 174th in order of time, at Bonn the same year the
42d, and at Liegnitz in 1871 the 225th.111

As we move on into the earlier part of this century we find the same
dismal picture of increased susceptibility correlated with increased vaccination coverage.
Dettman and Kalokerinos describe a visit they
paid to the Philippines about 15 years ago:

. . . We were fortunate enough to address their own medical (and)
health officials where we reminded them of the incidence of smallpox in formerly
"immunized" Filipinos. We invited them to consult their own medical records and
asked them to correct us if our own facts and figures disagreed. No such correction has
been forthcoming, and we can only conclude that between 1918-1919 there were 112,549 cases
of smallpox notified, with 60,855 deaths. Systematic (mass) vaccination started in 1905,
and since its introduction case mortality increased alarmingly. Their own records comment
that "The mortality is hardly explainable." 112

Speaking at a 1973 environmental conference in Brussels, Professor
George Dick admitted that in recent decades, 75 percent of those that have contracted
smallpox in Britain, have had prior a history of vaccination. In that "only 40%"
of children were vaccinated (and at most 10 percent of adults), such figures clearly
indicate that the vaccinated--as in the much earlier historical record--continue to show a
higher tendency to contract the disease. Dick also admitted that smallpox had been
eradicated in certain tropical countries without mass vaccination.113 (Table VIII reveals that in the 16 year period preceding the year the WHO
eradication campaign was launched--38 additional countries had ceased to report any
smallpox cases.)114

A. Hutchison writing in the Journal of the Royal Society in 1974, referred to the
smallpox vaccines "lack of potency" and the inadequacies of other measures for
containment, in his words, "I have given details of the various outbreaks of smallpox
in Britain and where they were diagnosed. These clearly indicate that the (preventive)
measures are most ineffective.115

An article in the New Scientist indicates that "The smallpox family of viruses
is genetically unstable," and that new viral strains which threaten the "WHO
smallpox eradication programme, could emerge anywhere.116 It is thus of interest that in a 1980 article in the Australasian Nurses
Journal, Dettman and Kalokerinos pointed
out that electron-microscopy cannot distinguish between the various "poxviruses.117 (According to D, de Saving of IDRC, as of
1990 DNA sequencing can make the distinquishingment. What is not known though, is whether
this has any beating on the reporting of the various "pox" diseases worldwide.)
This fact led them to raise a vitally significant question "as to whether smallpox
may be declared conquered, (it's estimated that only 10 percent of the world population
actually received the vaccine) with the possibility of it masquerading under the guise of
a similar pox." Their line of evidence and reasoning is summarily stated:

. . . we claim that if the evidence is honestly evaluated that
smallpox has actually been prolonged and that the so called protective vaccinations
actually put the recipient at risk from . . . the disease itself. Authorities now realize
this and the 'top world' countries are making vociferous protests about third world
countries continuing use of smallpox vaccination because (a) suddenly it has become
recognized that it is an extremely dangerous procedure, (To give some idea of the
vaccine's dangers, it was reported--in the late sixties--that annually, roughly 3,000
children were experiencing varying degrees of brain damage due to the smallpox vaccine;
and according to G. Kiftel in 1967, smallpox vaccination damaged the hearing of 3,296
children in West Germany, of which 71 became totally deaf.117)and (b) it has now been conquered. The ultimate in ingenuity. . . .118

In turning to recognized textbooks on human virology and vertebrate
viruses we find that attention has been given since 1970 to a disease called
"monkeypox," which is said to be "clinically indistinguishable from
smallpox." Cases of this disease have been found in Zaire, Cameroon, Nigeria, Ivory
Coast, Liberia, and Sierra Leone (by May 1983, 101 cases have been reported). It is
observed that " . . . the existence of a virus that can cause clinical smallpox is
disturbing, and the situation is being closely monitored."119 (For a highly detailed account of the history of this disease and efforts to
eradicate it, which further corroborates these observations, see, Razzell P., The
Conquest of Smallpox, Caliban Books, United Kingdom, 1977.)

Another basic issue that has never been raised in the programming, or evaluation contexts
of Official Development Assistance supported mass immunization, is the requirement for
effective monitoring and research on potential vaccinal adverse effects. The issue of
vaccine dangers and damage is obviously a rather unpleasant subject that no one really
enjoys thinking or talking about. In fact it appears to have been totally ignored in both
the planning and execution phases of Canada's International Immunization Programme(CIIP).
Furthermore, the recently completed Qperational Review of CIIP 1986--1991, which
according to its sub-title was supposed to address inter alia ". . . lessons learned
in the first three years," failed to even raise the two very fundamental issues of
vaccine effectiveness, and vaccine damage.120
In special PHC-EPI research conducted for the CIDA Evaluation Division, the conclusion was
reached that the extensive literature written on the subject of immunization, adverse
reactions and contra indications, points clearly to the reality that "massive
immunization programs carry with them a number of very real risks and hazards.121

According to information recently provided by CIDA's Health and Population Directorate the
World Health Organization as of October, 1990 has instituted a policy for "adverse
event monitoring" in Developing World Immunization activities. A definitive policy
statement on this issue titled Monitoring
of Adverse Events Following Immunization, is apparently available as of April 1991.
The implications of VMO's recognition of the significance of this issue to the setting of
public policy priorities for EPI research, monitoring and evaluation should be apparent.
In order to provide some background on why the WHO is now taking these measures, a few
critical observations follow.

In recognition of potential vaccine dangers, David Karzon of the Vanderbilt University
School of Medicine raises important policy considerations with respect to mass
immunization programs in the Editorials section of the New England Journal of Medicine.

. . . there are two compelling reasons for reinspection of the
process offormulating and implementing our immunization program: the emergence of new
societal considerations and responsibilities; and the need for a fuller public disclosure
of the costs of disease prevention . . . we as a society have not recognized and accepted
all the costs . . . costs measured not only in dollars spent or saved, but also as adverse
biologic reactions.

Literally no drug or procedure used in medicine is risk free. Immunizing antigens,
originating from complex biological materials or arising as genetically attenuated live
agents, have their own peculiar endogenous hazards, Complications . . . are particularly
apt to be visible in mass immunization campaigns. . . . The quality of the data base for
national decisions is critical because any vaccine recommendation carries such a vast
Potentialfor harm or good.122

It is unfortunate that UNICEF EPI field reports tend to dismiss the
concerns raised by "targeted" locals to the issue of vaccine damage, as based on
misinformation provided by unreliable local health staff, or the ignorance of fearful
mothers, both of whom need re-education. For instance a recent UNICEF annual project
report in discussing EPI stated, "A WHO-UNICEF team found that drop out rates were
high because of the fear of side effects as expressed by mothers, (and) misinformation
about contraindications . . . as communicated by health workers. . . . As a result,
increased attention is being directed toward health education. . . ."123

To say the least, it seems incongruous that this issue is paternalistically ignored as an
insignificant concern raised by the misinformed and the ignorant, when Canadian citizens
are being alerted by the media that the Canadian Government is expected to announce
"disaster relief" to families "of vaccine damaged children."124 This relatively recent report suggests that
vaccine damage is likely more pervasive a problem than is generally acknowledged or
believed. In fact, it appears that chronic under-reporting of vaccine-induced morbidity,
disability, and mortality appears to be the norm. Probably the most erudite scholar who
has thoroughly investigated the issue of vaccine hazards, is Sir Graham Wilson. As
Honorary Lecturer in the Department of Bacteriology at the London School of Hygiene and
Tropical Medicine, the following observations are excerpted from an earlier lecture series
delivered at that school.

The risks attendant in use of vaccines and sera are not as well
recognized as they should be. Indeed our knowledge of them is still too small, and the
incomplete knowledge we have is not widely disseminated.. a very small proportion [of the
actual numbers of vaccine accidents] . . . have been described in the medical literature
of the world.

. . . a large number of accidents--I suspect the majority--have never been reported in
print, either through fear of compensation claims, or of giving a weapon to
antivaccinationists . . . I have come to the conclusion that no vaccine or antiserum can
be regarded as completely safe . . . no vaccine or antiserum that has yet been used has
been free from complications or accidents . . . [with respect to assessing the
"degree of possible danger" he indicates that] Unless both the numerator and the
denominator are known, quantitative assessments may fall wide of the true mark. Moreover,
the risk, even for a single vaccine, is not uniform. It varies, among other things, with
the immunological status of the population concerned..

The inherent danger of all vaccination procedures should be a deterrent to their
unnecessary or unjustifiable use. Vaccination is far too often employed, especially in the
developing countries . . . and should not be used as an [instead] excuse from applying the
well tried standard methods for the prevention of infectious disease. Most important is it
to realize the potential dangers of mass immunization. In such an operation time does not
permit an inquiry into the suitability of each individual subject for vaccination.125

A strong echo of Wilson's conclusion that vaccine damage is chronically
under reported, is found in the official minutes of the 15th session of the US Panel of Review of Bacterial Vaccines and Toxoids with
Standards and Potency.

Many physicians are not cognizant of the importance of reporting
untoward reactions, or may be unaware of their clinical features. Further, both physicians
and manufacturers have been held liable for damage suits by patients who may suffer
adverse effects from established vaccines. All of these factors undoubtedly discourage
reporting; without some other form of surveillance, definition of the rates and
significance of untoward reactions to current and future vaccines cannot be ascertained.126

H.S. Martland, former Chief Medical Examiner for Essex County New York,
describes how the above unawareness actually translates into practice:

Deaths from brain and spinal cord diseases (poliomyelitis,
encephalitis, and meningitis) resulting from . . . immunizations sometimes are attributed
to other causes, because doctors are not sufficiently alerted to the connection between
immunizations and the deaths. . . .127

Neustadter maintains that the research on vaccine side effects by the
pharmaceutical industry remains seriously marginalized due to a significant number of
vaccine reactions going unreported, and the fact that it is often difficult to attribute
delayed effects with a vaccine. He further suggests that the reason that the
medico-pharmaceutical industry has consistently failed to address the unanswered question
of the long term effects of vaccines, stems largely from their overriding interest in the
active promotion, and rapid marketing of vaccines. Investigation of their adverse side
effects generally remains a non-priority issue, insofar as such efforts may undermine the
public's acceptance of their products.128 On the other hand, Snead suggests that when laboratories go public to the media
and confirm that "no known problems" exist, this does not mean that scientists
have researched to the limits of their knowledge and found no side effects, but rather
that no research has actually been done.129

Although there is compelling evidence that vaccine induced damage remains chronically
under-reported, it is of interest that B. Bloom of the Albert Einstein College of
Medicine, openly admits that there is today an emerging reluctance on the part of
medico-pharrnaceutical industry to further develop vaccines, for both the developed and
Developing Worlds. According to Bloom, this reluctance stems from the fact that financial
losses due to the "liability" of established vaccines, actually exceed the
"profits" derived from them.130 In this vein, Mendelsohn indicates that vaccine costs have
"skyrocketed" as a consequence of multiple jury awards to damaged children. In
his words:

As more and more parents begin to recognize the link between vaccines
and their child's condition--epilepsy, convulsions, mental retardation, cerebral palsy,
Sudden Infant Death, etc.--lawsuits have become commonplace. As drug companies exit the
vaccine field, public health authorities worry about vaccine shortages. 131

It would be instructive to consider the range of substances--additional to the attenuated
virus etc. normally found in vaccine products. Specific viruses and bacteria are grown in
the following substances, with their foreign proteins (antigens) including those derived
from: pig or horse blood; rabbit brain tissue; dog and monkey kidney tissue; chicken and
duck egg; and calf serum. (It is generally acknowledged that any foreign substances
including proteins--which have not been filtered through the body's normal digestive
assimilative, and excretory processes, can be highly toxic when freely ranging in the
lymphatic and blood systems.) Other foreign additives normally found in various vaccines
include:

formaldehyde--(a known carcinogen)

thimerosal--(an organomercurial antiseptic--49% mercury--although the
mercury is "closely bound," it nonetheless is a toxic metal difficult for the
system to eliminate)

Commenting on the inclusion of such substances in vaccine products, R.
Moskowitz indicates that "the fact is that we do not know and have never attempted to
discover what actually becomes of these foreign substances, once they are inside of the
body."133 Although there are
"rigid" precautions in licensing the use and quantity of these common
stabilizers and preservative, it certainly seems self-evident that there should be further
research to better determine what relationship--if any--exists between such poisons, and
various adverse reactions.

By principally focusing on stimulating the production of antibody--which increasing
evidence suggests is only one marginal indicative factor among many in immunity to
disease--while ignoring the basic multiple determinants of natural immunity (health),
viruses, foreign antigens and proteins are placed directly into the body tissues and are
in turn carried throughout the circulatory system (without censoring by the liver) giving
them direct accessibility to all of the body's vital organs and systems. Furthermore, it
is an EPI strategy that this short-circuiting of the body's natural defense system is
imposed at an extremely vulnerable time of life.134 The stage has thus been set for the advent of a wide range of adverse
complications and sequelae.

What follows is a simple listing of observed side effects of specific vaccines, or when
noted toxoids. Practically all of the conditions listed are commonly reported in the
medical literature as linked to the prior administration of the particular vaccine or
toxoid noted. A few conditions listed--such as the sudden infant death syndrome linked to
the pertussis vaccine--are not admitted by mainstream medicine as an adverse effect of
that particular vaccine, however the research as referenced is reputable and points
otherwise. (The vaccines covered in this section have been confined to those prescribed in
the Universal Childhood Immunization program.)

MEASLES

atypical measles (a more serious form of measles)

encephalopathy (irreversible brain damage)

subacute sclerosing panencephalitis (progressive brain damage which can
lead to death)

ataxia (incoordination in voluntary muscular movements)

mental retardation

aseptic meningitis (inflammation of the membranes of spinal cord or
brain)

There is a considerable range in estimates given as to the frequency of damage being
produced by particular vaccines. A case in point is the American manufactured DPT vaccine,
for which the claim is made that only 1 in 300,000 vaccinates exhibit permanent neurologic
damage,141 whereas other
researchers suggest that permanent damage levels can reach as high as 1 in 300.142 Coumoyer's research findings fall between
these two extremes for permanent neurologic or brain damage. Her conclusions indicate that
the following varied rate reactions occur in vaccinates, per number of children
vaccinated:

Persistent crying--1 in 20

High fever--1 in 66

High pitched screaming--1 in 180

Convulsions--1 in 350

Shock like condition or collapse--1 in 350

Acute brain disorder--1 in 22,000

Permanent brain damage--1 in 62,000

Death--1 in 71,600.143

Again to illustrate the great variation in estimates, a relatively
recent study at UCLA (see Cody et al, ref 136) found that as many as one in every 13
children exhibited persistent high pitched crying after receiving the DPT vaccine. In
reference to this specific reaction, physician B. Young states that "This may be
indicative of brain damage in the recipient child."144

According to data researched by Coulter and Fisher, of the 3.3 million children vaccinated
yearly in the US: 16,038 have high pitched (encephalitic) screaming (which is considered
by many neurologists as indicative of central nervous system irritation); 8,484 have
convulsions; and 8,484 undergo collapse; "for an annual total of 33,006 cases of
acute neurological reactions within 48 hours of a DPT shot." The authors further
suggest that there is a strong basis for concern with respect to the long term reaction to
the DPT vaccine.

Severe neurologic sequelae may . . . occur after vaccination in the absence of an acute
reaction. When the baby reacts to a DPT shot with "a slight fever and fussiness for a
few days" this may be, and often is, a case of encephalitis which is quite capable of
causing even quite severe long-term neurologic consequences . . . . They further suggest
that any who would dismiss this possibility, must first establish a basis for
distinguishing between post-vaccinal encephalitis and encephalitis arising from other
causes.145

As a final observation on the issue of short term vaccine dangers, is the postulated
linkage of immunization with the "mysterious" problem of sudden infant death
(SIDS) in which infants can die "suddenly and quietly" in their cribs.
Australian microbiologist Glen Dettman explains that when large amounts of an antigen are
given the body responds by a massive release of adrenal products including: cortisol,
adrenalin, and an excessive level of endorphins, actually "as much as a thousand
times more than is normally released by the brain." He goes on to observe that:

The endorphins will suppress respiration and cardiac function. Thus
if a child with malnutrition, or an immune problem, is given a load of antigen larger than
it can handle--and this antigen may be an immunisation--endorphins may result in
respiratory or cardiac failure and death.146

Torch's research indicates that two-thirds of 103 infants who were
victims of the sudden death syndrome had been immunized with DPT vaccine within the 3 week
period preceding death, with many dying within a day of receiving the vaccine.147 In a widely debated occurrence of SIDS in
Tennessee (USA), in which eleven infant deaths occurred within eight days of a DPT
vaccination, (nine from the same lot), and five within 24 hours of vaccination (four from
the same lot). Mortimer reported that the probability of this being mere chance or
coincidental to be between 2 and 5 in 1,000;148 whereas Shannon reported a much lower chance association of 4 and 5 in 10,000.149

Leaving the continuing controversies that exist over the extent and nature of observable
adverse reactions to vaccines, we go on to the equally serious spectre of delayed
reactions and the larger unanswered questions which surround the long term consequences of
immunization. (The material in both this and the following section on "Immunization
and Immune Malfunction" is afforded not necessarily as definitive and factual
conclusions, but rather as preliminary research observations on vital--albeit
controversial--issues and questions which undoubtedly merit further examination, research
and analyses.) We began the exploration of this issue by reviewing some basic concepts and
concerns relative to the strongly suspected linkage between live viral vaccines and the
enormous escalation of varied auto-immune disorders.

Joshua Lederberg, a Stanford University School of Medicine geneticist and Nobel Prize
winner, was perhaps the first to raise the warning that the use of live virus vaccines in
mass immunization campaigns represents "biological engineering on a rather large
scale." He goes on to comment:

While these [vaccines] are thought to be of indubitable value for
preventing serious diseases, their global impact on the development of human beings of a
side range of genotypes is hard to assess at our present stage of wisdom. . . . Live
viruses are themselves genetic messages used for the purpose of programming human cells
for the synthesis of immunogenic virus antigens.150

Researchers such as Buttram postulate that the use of live viral
vaccines in mass immunization programs introduces foreign genetic material into the human
system, which has precipitated an unprecedented escalation of various auto-immune
disorders in recent decades. These are disorders wherein antibodies or immune cells
indiscriminately attack the tissues of one's own body-mind complex.151

Harvard graduate and physician, R. Moskowitz, explains how the live viruses in vaccines
can, in the long term, lead to such auto-immune disease conditions. Vaccinal attenuated
viruses attach their own genetic "episome" to the genome (half set of
chromosomes and their genes) of the host cell, and are thus capable of surviving or
remaining latent within the host cells for years. The presence of this foreign antigenic
material within the host cell sets the stage for their unpredictable provocation of
various auto-immune phenomena such as herpes, shingles, warts, tumors--both benign and
malignant--and diseases of the central nervous system, such as varied forms of paralysis
and inflammation of the brain.152

Markowitz further poses the caution that vaccines do not act by merely producing pale or
mild copies of the original disease, but all of them commonly produce a variety of
symptoms of their very own. In some cases "these illnesses may be considerably more
serious than the original disease, involving deeper structures, more vital organs, and
less of a tendency to resolve spontaneously. Even more worrisome is the fact that they are
almost always more difficult to recognize."153

A British Medical Journal article by Miller et al, reports that "Various
German authors have described the apparent provocation of multiple sclerosis
by--vaccination against smallpox, typhoid, tetanus, polio, and tuberculosis."154 No less disconcerting is the warning raised
by Rutgers University Professor R. Simpson when he addressed science writers at a seminar
sponsored by the American Cancer Society:

Immunization Programs against flu, measles, mumps, polio and so forth
may actually be seeding humans with RNA to form latent proviruses in cells throughout the
body. These latent proviruses could be molecules in search of diseases, including
rheumatoid arthritis, multiple sclerosis, systemic lupus erythematosus, Parkinson's
disease, and perhaps cancer.155

As if echoing Simpson, Dettman also raises the caution: that "some
of the attenuated strains of vaccines that we advocate may be implicated with . . . a
number of degenerative diseases including rheumatoid arthritis, leukaemia, diabetes and
multiple sclerosis."156

A study in Science reported a notable similarity between certain diffffent viruses
(including measles and influenza) and the protein structure of the brains protective
myelin sheaths. This being the case, antibodies induced by live viral vaccines could well
be cross reacting and attacking brain cells.157 Medical historian Harris Coulter has developed a systematic and comprehensive
thesis that childhood immunizations frequently result in a demyelinating encephalitis.(As
already noted, encephalitis [inflammation of the brain] has been associated with the
pertussis, tetanus, and measles vaccines.) This condition prevents the normal development
of the protective myelin sheaths of the brain and nerve cells during infancy and early
childhood. Such adverse pathologic changes may, on a visible level, lead to a range of
leaming disabilities and behaviourial problems, (As many as one in five elementary school
children are now considered to have some form of minimal brain damage."158 It is also estimated that in the US over one
million children are medicated with powerful amphetamine drugs.159) 158, 159 which are now
being encountered in the West with increasing frequency.160

Bruce Rabin, a professor of pathology and psychiatry at Western Psychiatric Institute,
Pittsburgh has found evidence that approximately one-third of all cases of schizophrenia
are auto-immune in nature, with immune bodies attacking the brain cells.161 When we consider the alarming increase in
the numbers of schizophrenic cases, and the now credible "viral hypothesis of mental
disorders,"162 childhood
vaccine programs can be considered as highly suspect in playing a causative role.

Medical Professor, R. Mendelsohn summarily comments that:

While the myriad short-term hazards of most immunizations are known
(but rarely explained), no one knows the long-term consequences of injecting foreign
proteins into the body . . . . Even more shocking is the fact that no one is making any
structured effort to find out.

There is growing suspicion that immunization against . . . childhood diseases may be
responsible for the dramatic increase in auto-immune diseases since mass inoculations were
introduced. These are fearful diseases such as cancer, leukaemia, rheumatoid arthritis,
multiple sclerosis, Lou Gehrig's disease, lupus erythematosus, and the Guillain-Barré
syndrome. . . . Have we traded mumps and measles for cancer and leukaemia? 163

Noted Russian specialist in neuro-pathology, A.D. Speransky, concurs
with the foregoing premonitory insights when he warns that post-vaccinal diseases might
occur long after the operation has been forgotten. He raises the disquieting observation
that ". . . it is conceivable that by these methods we may be crippling
humanity."164

Whether considering the short or longer term dangers of immunization programs, it is
further unsettling when we consider the evidence that the public cannot really place much
confidence in organized medicine to conduct itself in an honest and forthright fashion.
For example, in 1982 the Forum of the American Academy of Paediatrics (AAP) rejected a
proposed resolution which would have ensured that the:

AAP make available in clear, concise language information which a
reasonable parent would want to know about the benefits and risks of routine
immunizations, the risks of vaccine preventable diseases and the management of common
adverse reactions to immunizations.165

There is a growing body of evidence that vaccinations damage the immune system itself. For
example, during a placebo controlled trial of acellular pertussis vaccines, a cluster of
invasive bacterial infections with fatal outcome occurred among vaccinated children, as
compared with unvaccinated children of the same birth grouping. A review of the trial data
led to the conclusion that "The hypothesis of an immunosuppresive effect of the
vaccines, which would explain the deaths . . . could not be refuted by the data."166

It is the studied conclusion of H. Buttram and J. Hoffman (Harold Buffram M.D., a graduate
of Oklahoma Medical School, with a post internship in internal medicine, has over 30 years
of medical practice in the State of Pennsylvania. John Hoffman Ph.D., is a Cell Biologist
and when interviewed was serving as a biomedical researcher in the Department of Molecular
Biology at the University of Wyoming), that early childhood vaccination "cannot help
but have adverse effects on the immunologic system of the child, possibly leaving this
system crippled in its ability to protect the child throughout life . . . . opening the
way for other diseases as a result of immunologic dysfunction."167

In reviewing their hypothesis of vaccine induced immune malfunction the evidence they
present is substantive (citing numerous references, including four recognized textbooks on
paediatrics and immunology), and their line of reasoning convincing. The following
observations are made:

"For many years immunologists have been aware of a state of anergy
(immunological unresponsiveness) following certain vaccinations"

A US Center for Disease Control examination of 700 Peace Corps volunteers
who had undergone a set of multiple vaccine injections in the US before departure,
exhibited an extremely weakened immune system response to the vaccine (HDCV) administered
after their arrival overseas

Vaccination against one disease seems to provoke another (on this point,
a physician's report of 15 case histories, over a five year period, where
diphtheria-pertussis vaccination lead to paralytic polio is described, and Sir Graham
Wilson is quoted [this doc. ref 7], "when a vaccine is injected . . . a latent
infection that might have given rise to no illness is converted into a clinical
attack.")

Vaccines have been implicated by numerous investigators as playing a
"causative or contributory role" to various auto-immune and degenerative
diseases, and suggests that their role in the onset of allergies or their worsening, and
lowered resistance to infections needs to be further investigated

Given the one cell--one antibody rule, once an immune body (plasma cell
or lymphocyte) becomes committed to a given antigen, it becomes inert and incapable of
responding to other antigens or challenges to the immune system. It is estimated that up 7
percent of the body's overall immune capacity is committed in the natural immunological
response to the usual childhood diseases, whereas a child who undergoes the course of
routine childhood vaccines could be realizing a committal level of up 70 percent

The consequences of this significantly higher committal could result in
increased susceptibility to other infections, allergies, and auto-immune diseases. (This
particular observation is based upon sophisticated research carried out by the Arthur
Research Corporation, based in Tucson, Arizona.)

Evidence indicates that maternal immunization "may remove (abrogate)
immune defense from the level of the mucosa, thus potentially weakening mucosal
resistance" (immunologists have long recognized that the mucosal surface serves as a
"first line of defense" against infection)

Abnormal drops in the ratio of helper-to-suppresser T--lymphocyte cell
subpopulations in healthy subjects (a condition now associated with AIDS, and possibly
linked to transient hypogammaglobulinemia), observed after tetanus booster immunization

Circumstantial evidence indicates that "cross-cultural" mass
immunization programs may be predisposing the onset of acquired immune deficiency syndrome
in "virgin soil" populations as found in the Developing World, "which have
not historically been subjected to the common diseases of Western civilization"

There remains a great need to conduct careful studies on the potential
"immunosuppressive effects of vaccines," particularly with respect to
"cross-cultural immunizations where exaggerated adverse responses would more likely
be detected"

Where there is already advanced impairment in a child's general immune
system, the injection of multiple antigens (vaccination), can weaken it further to the
point of precipitating death in the vaccinate

Before public endorsement is accorded to the extensive usage of vaccines,
certain preconditions should be addressed which include: a comprehensive evaluation of the
multiple factors which constitute the etiologic basis of infectious disease; and the full
range of factors and influences which determine natural resistance to infection and
disease; with a full public disclosure of such research data.168

Despite the fact that immune malfunction is "often delayed,
indirect, and masked, (and) its true nature is seldom recognized," there is now
sufficient evidence to suggest that growing disclosure of both the short and longer term
dangers of current vaccination programs will serve to precipitate public demand for
research to examine danger-free alternative methods for the prevention of infectious
diseases.169

J.E. Craighead, in summarizing the results of a workshop on "Disease Accentuation
after Immunization with Inactivated Microbial Vaccines," sponsored by the US National
Institutes of Health, indicated that the process of:

. . . immuno-prophylaxis can be carried out safely only when the
natural history and pathogenesis of a disease is understood. In each of the conditions
considered at the workshop, this detailed knowledge was lacking when vaccine trials were
initiated in man. Had the vaccines induced lasting solid immunity, prolonged protection
might have resulted, although this conclusion is far from certain. Moreover, production of
circulating antibodies or induction of cellular immunity (or both) may be hazardous when
local immune mechanisms of the mucosa are not operative.

Accentuation of disease was an unexpected complication of immunization in each of the
conditions. Disease was accentuated when the subject (vaccinate) was exposed again,
experimentally or under natural circumstances, weeks or even years after completion of the
immunization regimen. Prolonged, intensive surveillance of immunization subjects
apparently is a requirement. . . . One can only wonder whether or not recipients of
currently licensed vaccines . . . that provide variable and transient immunity are being
followed adequately . . . . Accumulating evidence strongly suggests that susceptibility to
infection and disease is affected by still undefined constitutional influences. 170

It is evident that Craighead's key question of what constitutes the
still undefined "influences" will be effectively resolved only when the focus of
selective medicine is able to make a radical shift towards displacing its present
adventitious arsenal of vaccines and toxic drugs, with the normal and natural requisites
of life and health. This is stated because the historical record, and common sense point
to the latter approach as constituting the only sound basis for ensuring--not
undermining--immune functionality, thus effectively resolving the actual underlying causes
of both infectious and degenerative disease in man.

There is indeed more than sufficient evidence to warrant far greater caution and
questioning, than is now evident in the public drumbeating, idealism, and unqualified
affirmations promoting the safety and effectiveness of Universal Childhood Immunization
Programs. In fairness, it can be noted that some cautions have been raised on this issue
from within medical circles. In summarizing an article on whether prevention of
post-immunization adverse effects is possible, the editor(s) of Postgraduate Medicine
recommend that:

Parents must be informed of the rare possibility of serious adverse
effects, including seizure and allergic reaction. Every physician who administers vaccine
therefore needs to become familiar with the reactions that may occur with each immunologic
agent used. The best safeguard against litigation, when and if a serious reaction follows
vaccination, is the indication that these considerations were discussed and that an
informed choice was made.171

Nonetheless, we find that UCI-EPI as it has been generally conceived and
executed represents two major departures from the time honoured ethics and traditions of
medicine. These are:

that all forms of treatment should be individualized, particularly when
prescribing or injecting substances which carry the potential for disease, disablement,
and death; and

the objectively informed patient (or parent) should always have absolute
freedom to accept or reject any given measure or therapy, and have reasonable opportunity
to consider alternatives.172

Just as environmentalists rightly challenge the appropriateness and
right of big business interests to pollute our fragile natural environment with man-made
chemicals, there arises the more personal, urgent and serious matter of protecting the
precious body-mind complex from foreign and complex biological products that may well be
touted as safe today, but condemned as dangerous tomorrow. Indeed scientists and
physicians now openly admit that they have only a limited knowledge of the short term, and
even less understanding of the long term consequences of challenging the bio-immune
systems of children with a myriad of manufactured vaccines and related toxins.

This in turn poses the more basic question of whether medical and political authorities
have the actual right--by reason and moral justice--to compel and expose unnumbered
children the world over to undertake what are in fact unnecessary and potentially
dangerous risks to their life and long term health. It is reprehensible that such actions
continue to be enforced by authorities, while parents and local health workers are not
accorded any practical knowledge of the known dangers involved, and the extent to which
there prevails a general ignorance of the longer term consequences.173

It goes without saying that monopolization is just as dangerous in public health as is it
is in the field of general business. The human experience has demonstrated time and again
that monopoly and compulsion in any field inevitably brings stagnation, whereas freedom of
choice and the opportunity to explore alternatives brings genuine progress.174BANE OR BOON? SELECTIVE
MEDICINE IN PRIMARY HEALTH CARE

Given the fact that UCI stands at the forefront as a centrepiece in the
"selective medicine primary health care model" (around which has grown a
powerful multi-billion dollar pharmaceutical industry), we must reconsider its overall
relevance to human health. In selective medicine the relationship becomes one where the
professional alone holds the authorized enlightenment and skills, while the community and
its people come to represent the baser qualities of ignorance and subservient faith. This
dynamic engenders in the community an unhealthful respect for officially authorized
solutions, even when their effectiveness is in fact illusory. The Aboriginal peoples of N.
America have now reached the unenviable distinction of being not only the most thoroughly
immunized and medically drugged, but also the sickest group on the continent (e.g., by the
late 1970s, the Canadian Aboriginal infant mortality rate was double that of the general
population, with life expectancy at 36 years compared with 62 years among Canadians
generally.)175

Furthermore, alarming evidence suggests that in many Aboriginal communities there is a
continuing escalation in degenerative diseases and social malaise. Both paleopathological
and historical data convincingly indicate that when living a way of life closely
predicated upon natural law, and free of adventitious medical interventions, North
American Aboriginals were distinguished as being one of the healthiest of world peoples.176

A more recent, albeit equally instructive picture can be fund among the Maori (Polynesian)
people, who likewise have been especially earmarked by their national government (New
Zealand) to receive the benefits of selective medical intervention. A study covering the
period of 1968 to 1971 found that when compared with their racial counterparts who live in
the remote island nations of the Pacific, the New Zealand Maoris appeared more inclined to
suffer from infectious disease, rheumatic fever, and tuberculosis. They also seemed
considerably more prone to develop degenerative conditions such as heart disease and
diabetes, afflictions which were then virtually foreign to the remote island peoples. (In
fact, among Maori women in the age grouping of 35 to 55, coronary heart disease was four
to five times as frequent as among women of the same age group living on the atolls of the
central Pacific.)177

In the final analysis, disquieting evidence--much of which is not cited in this
research--suggests the overall irrelevance of selective Western medicine to effecting
longevity and ensuring general freedom from a range of infectious and degenerative
diseases. Furthermore, as a system, it continues to significantly contribute to human
morbidity and mortality"178
(e.g., it has been shown in the USA, Holland, Israel and other developed nations that when
physicians engage in a complete strike, within a week to 10 days death rates actually
plummet, in some cases by as much as 60 percent).

It would be appropriate here to quote Illich's unambiguous observation that "Society
can have no quantitative standards by which to add up the negative value of illusion,
social control, prolonged suffering, loneliness, genetic deterioration and frustration
produced by medical treatment."179 In reference to selective medicine's central focus on absolving mankind from
giving due respect to the natural laws of cause and effect, Mahatma Gandhi shares the
following perspective.

I was at one time a great lover of the medical profession. . . . I no
longer hold that opinion. . . . Doctors have almost unhinged us. . . . I regard the
present system as black magic. . . . Hospitals are institutions for propagating sin. Men
take less care of their bodies and immorality increases. . . . ignoring the soul, the
profession puts men at its mercy and contributes to the diminution of human dignity and
self control. . . . I have endeavoured to show that there is no real service of humanity
in the profession, and that it is injurious to mankind. . . . I believe that a
multiplicity of hospitals is not test of civilization. It is rather a symptom of decay.180

Evidence suggests that Western medicine's over specialization and
singular focus on pathology has literally obfuscated its perception and undermined its
faith in the preventive and restorative power of the normal requisites of health. To a
great extent it thus remains as an inexact and ever shifting system of trial and error,
apparently more interested in maintaining its monopolistic pecuniary interests and
professionalist pride, than in opening itself to new avenues of thinking and practice.

With all seriousness then we must raise the question as to whether we can realistically
expect the self-same medico-industrial system that has for so long offered humankind
little more than palliative and pathological inducing vaccines and drugs, to offer us
anything better. (To obtain additional background on the practical impacts which the
medico-industrial system of the West is having on the Developing World, please refer to
Annex I--Problems With Developing World Medicalization and the Traditional Medicine
Alternative.) It is here that we turn to consider the larger issue of what constitutes
safer, more effective and sustainable approaches to ensuring the development and
maintenance of human health.